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Ocular Surface Disease and Quality of Life in Patients With Glaucoma

2012; Elsevier BV; Volume: 153; Issue: 5 Linguagem: Inglês

10.1016/j.ajo.2012.01.017

1879-1891

Halit Oğuz,

Corneal surgery and disorders

I read with interest the valuable cross-sectional study performed by Skalicky and associates 1 Skalicky S.E. Goldberg I. McCluskey P. Ocular surface disease and quality of life in patients with glaucoma. Am J Ophthalmol. 2012; 153: 1-9 PubMed Scopus (172) Google Scholar in the January 2012 issue of the Journal. The authors investigated the relationship between ocular surface disease and glaucoma-related quality of life, glaucoma severity, and treatment in patients with open-angle glaucoma. They found that ocular surface disease index (OSDI) scores and the number of patients with ocular surface disease (OSD) increased with increasing glaucoma severity. In addition, OSDI was significantly correlated with Glaucoma Quality of Life-15 summary score, glaucoma severity, multiple topical glaucoma medications, worse eye mean deviation and pattern standard deviation, use of topical beta blockers, topical carbonic anhydrase inhibitors, daily dose of benzalkonium chloride, and glaucoma filtration surgery. In addition to preservatives in glaucoma medications, they mentioned in the article that elevated and exposed blebs can aggravate OSD symptoms. I think this merits more discussion and explanation: McDonald and Brubaker previously suggested tear meniscus and meniscus-induced thinning, and ocular surface irregularities had ectopic meniscus and a thinned meniscus area and resultant staining. 2 McDonald J.E. Brubaker S. Meniscus-induced thinning of tear films. Am J Ophthalmol. 1971; 72: 139-146 PubMed Scopus (96) Google Scholar They reported that tear film fractured in these thin areas. Also, they predicted that perilimbal elevations such as filtering blebs have secondary tear menisci and adjacent thinning area. I think the ectopic meniscus and thinning area can be demonstrated by video-meniscometer. 3 Oguz H. Yokoi N. Kinoshita S. The height and radius of the tear meniscus and methods for examining these parameters. Cornea. 2000; 19: 497-500 Crossref PubMed Scopus (120) Google Scholar , 4 Oguz H. Noninvasive tear meniscometry in dry eye patients with Sjögren syndrome. Am J Ophthalmol. 2008; 145: 184 Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar Ocular Surface Disease and Quality of Life in Patients With GlaucomaAmerican Journal of OphthalmologyVol. 153Issue 1PreviewTo investigate the relationship between ocular surface disease and glaucoma-related quality of life (QoL), glaucoma severity, and treatment in patients with open-angle glaucoma. Full-Text PDF ReplyAmerican Journal of OphthalmologyVol. 153Issue 5PreviewWe thank Professor Oguz for commenting on our paper.1 While dysesthetic blebs following glaucoma drainage surgery contribute to symptomatic ocular surface disease (OSD), there is little data regarding the specific etiology.2,3 It is likely to be multifactorial. Budenz and associates,2 investigating 97 patients with unilateral trabeculectomy blebs, found that young age, bleb exposure in the interpalpebral fissure, height of the bleb adjacent to the cornea, and bubbles in the tear film on blinking were predictive of dysesthesia. Full-Text PDF