Management of Ocular Surface Disease in Glaucoma: A Survey of Canadian Glaucoma Specialists

J Glaucoma. 2020 Dec;29(12):1162-1172. doi: 10.1097/IJG.0000000000001659.

Abstract

PRéCIS:: Ocular surface disease (OSD) in glaucoma is an area for improvement in the management of patients with glaucoma. This study explores the knowledge of glaucoma subspecialists toward OSD in glaucoma, then provides a suggested treatment algorithm.

Purpose: To assess the attitudes, knowledge, and level of comfort of Canadian glaucoma specialists with respect to the assessment and management of OSD among patients with glaucoma.

Methods: Ophthalmologist members of the Canadian Glaucoma Society with fellowship training in glaucoma were contacted to participate in this cross-sectional survey study. Responses were recorded to statements regarding attitudes toward OSD in glaucoma, and assessment and management modalities. These were recorded primarily in the form of a Likert scale rated 1 to 7 from "strongly disagree" to "strongly agree." Descriptive statistics were generated, and mean and SD for responses on Likert scales.

Results: Thirty-six responses were included. All respondents agreed that comprehensive management of OSD could improve quality of life, 97% agreed it could lead to better glaucoma outcomes, whereas only 22% agreed it is presently being adequately managed in glaucoma practices. Respondents were asked to list all treatment modalities they felt knowledgeable about, ranging from 100% for optimizing topical glaucoma therapies to 31% for serum tears. Nearly all respondents (92%) agreed that a suggested algorithm for the treatment of OSD in glaucoma could improve their approach to management.

Conclusion: OSD is a common comorbidity of glaucoma. Although respondents overwhelmingly agreed that comprehensive management of OSD may lead to improved quality of life and glaucoma-related outcomes, only a small percentage felt it was presently adequately managed. Increasing knowledge related to the assessment and management of OSD in glaucoma may in the future improve patient care.

MeSH terms

  • Antihypertensive Agents / therapeutic use
  • Canada / epidemiology
  • Conjunctival Diseases / therapy*
  • Cross-Sectional Studies
  • Dry Eye Syndromes / therapy*
  • Eyelid Diseases / therapy*
  • Female
  • Glaucoma / therapy*
  • Health Care Surveys / statistics & numerical data
  • Humans
  • Intraocular Pressure / physiology
  • Male
  • Middle Aged
  • Ophthalmologists*
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Preservatives, Pharmaceutical
  • Prospective Studies
  • Specialization*
  • Surveys and Questionnaires
  • Tears / physiology

Substances

  • Antihypertensive Agents
  • Preservatives, Pharmaceutical