The Dry Eye Zone

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Abstract: Glaucoma and dry eye - large scale study

Wow - first thing of it's kind I remember coming across. More than 20,000 patients.

As always I'm glad to see anything underscoring and exploring the unique needs of glaucoma patients because of BAK risk issues. This one emphasizes yet another angle (see highlighted text in Conclusions) - I assume what they mean is patients failing to use their glaucoma drops because they themselves associate them with their increased dry eye symptoms.

German register for glaucoma patients with dry eye. I. Basic outcome with respect to dry eye.
Graefes Arch Clin Exp Ophthalmol. 2008 Jul 22. [Epub ahead of print]
Erb C, Gast U, Schremmer D

BACKGROUND: The purpose of this register was to determine the links between glaucoma, age, concomitant disease, medication, and dry eye in a large group of glaucoma patients.

METHODS: A total of 20,506 patients from 900 centers across Germany were included. The first 30 consecutive glaucoma patients at each center were recruited. Epidemiological data as well as information on glaucoma, medication, concomitant diseases, dry eye, and local symptoms were elicited by means of a questionnaire. We analyzed primary open-angle glaucoma (POAG), pseudoexfoliation glaucoma (PEX), and pigmentary glaucoma (PDG).

RESULTS: According to the register data, more women develop dry eye and glaucoma than men (56.9 vs. 45.7%). The most frequent concomitant systemic diseases were hypertension (48.1%), diabetes mellitus (22.5%), and dry mouth, nose, and skin (11.3%). As expected, the highest incidence of dry eye was found in those patients with dry mouth, nose, and skin. Dry eye occurred with dissimilar frequencies in association with the various glaucoma types: PEX>POAG>PDG. The incidence of dry eye increases with age. The gender difference in the occurrence of dry eye becomes apparent from the age of 50. Dry eye occurred more frequently when three or more antiglaucoma drugs were used and increased with the duration of glaucoma disease. CONCLUSIONS: We publish the first results from the German Glaucoma and Dry Eye Register. We found that the occurrence of dry eye is linked to several factors. Thus, the type of glaucoma has an impact on the risk of dry eye. The quantity of eye drops applied also plays a role in the development of the dry eye syndrome if more than three medications are used. While POAG is usually treated with one drug, PEX and PDG tend to be treated with multiple drugs. The gender difference in the occurrence of dry eye becomes apparent from the age 50 years. Because of the vicious circle of dry eye, antiglaucoma eye drops containing benzalkonium chloride compromises patient compliance. The results of the register are therefore of key relevance for the care of glaucoma patients.
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