Ocular Surface Anatomy and Physiology

Abstract

Ocular surface condition has a major impact on glaucoma treatment. Healthy ocular surface provides a favorable environment for antiglaucomatous eye drops efficacy. Ocular surface condition strongly relies on the ocular tear film, cellular arrangement of the cornea and the interfaces between the surfaces. Comprehensive collection of medical history, as well as detailed ocular surface examination under slit lamp and dry eye tests are highly recommended prior to glaucoma medical treatment. Treating the underlying condition must be started before or together with antiglaucomatous treatment.

Finding a perfect topical drug for glaucoma patients can be a challenging task. A perfect drug must not only be sufficiently effective, but also tolerated well by the patient. Evaluating antiglaucomatous drugs’ effects to ocular surface, three major factors must be considered: ocular surface toxicity, inflammation and allergy. Antiglaucomatous medications’ preservatives are also responsible for a vast amount of adverse effects.

Glaucoma is a life-time diagnosis, which requires IOP lowering treatment on a daily basis. Sometimes the target IOP is not achieved, so the surgical treatment is performed. Patients with healthy ocular surface have a higher chance for successful surgery, than patients with ocular surface damage.

Preserving healthy ocular surface during medical glaucoma treatment is not only important due to subjective patient discomfort, but also for patient compliance and long term treatment results, including surgical treatment and maintaining vision.