Strategies for the Management of Ocular Surface Disease in Glaucoma

Authors

  • William Trask MD, BSc
  • Adam Muzychuk, MD, FRCSC

DOI:

https://doi.org/10.58931/cect.2023.2121

Abstract

Ocular surface disease (OSD) is a common ophthalmological concern, with a prevalence in the Canadian population estimated at 25%. Amongst glaucoma patients, up to 60% report symptoms of OSD and up to 78% have clinical signs. Surface symptoms significantly reduce glaucoma-related quality-of-life (QOL), and there is emerging evidence to suggest that treatment of OSD may in fact improve intraocular-pressure (IOP) control and contribute to disease stabilization. The treatment of OSD in glaucoma has been receiving increasing attention, however specific recommendations remain sparse.

Ocular surface disease is known to represent a complex milieu of genetic predisposition, adnexal and periorbital status, environmental factors, systemic diseases, and medications (topical and systemic), amongst other predisposing factors. Effective management of this condition therefore demands that treatment be targeted to the specific clinical context. A 2020 study of Canadian glaucoma specialists found that, although 97% identified optimization of ocular surface disease as important for improving patient QOL, only 22.2% felt this was currently being managed adequately in the subspecialty clinic setting. Moreover, although all participants felt comfortable modifying topical hypotensive regimens to improve surface disease, only 61.1% were confident identifying patients who would benefit from topical steroids, and just 30.5% felt knowledgeable regarding the use and dispensation of autologous serum tears, which are increasingly deployed for treatment-resistant OSD in dry-eye practices. There is, therefore, an unmet need for clarity in the treatment algorithm to optimize OSD in glaucoma patients. Here, we discuss the therapeutic approach to these patients and present a suggested algorithm to guide management.

Author Biographies

William Trask MD, BSc

Dr. William Trask is a fourth-year ophthalmology resident at the University of Calgary. He obtained a Bachelor’s in Honors Neuroscience in 2016 and subsequently completed medical school at the University of Calgary. Dr. Trask’s research interests are broad and varied, ranging from cornea and ocular surface through intraocular/orbital malignancies, surgical glaucoma, and optic nerve. He also has a passion for translating technical innovation into the clinical space in the form of 3D printing/rapid prototyping and developing smartphone applications to aid examination and communication in ophthalmology. With a long-seated interest in medical education, he maintains an active role in admissions and instruction at the undergraduate medical education level and has been an invited lecturer to the local medical school. He has been extensively awarded for his clinical and academic achievements over the course of his training and serves as a journal and conference reviewer.

Adam Muzychuk, MD, FRCSC

Dr. Adam Muzychuk is an Assistant Professor of Surgery at the University of Calgary. He obtained his Medical Degree followed by residency training in Ophthalmology at the University of Calgary. Following residency, he completed fellowship training in anterior segment surgery at Université de Montréal. Dr. Muzychuk is the Scientific Meeting Chair for the Eye Physicians and Surgeons of Alberta (EPSAA), and has published in the areas of cornea, glaucoma, and retina. Currently, Dr. Muzychuk is involved in clinical trials on emerging technologies in cataract surgery. He has received more than ten academic awards including Best Paper of the Session at the ASCRS Annual Meeting, Best Glaucoma Paper from the Canadian Glaucoma Society, and the Master Teacher Award in the University of Calgary Section of Ophthalmology. Dr. Muzychuk practices in Calgary and remains active in undergraduate and postgraduate medical education at the University of Calgary.

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Published

2023-02-01

How to Cite

1.
Trask W, Muzychuk A. Strategies for the Management of Ocular Surface Disease in Glaucoma. Can Eye Care Today [Internet]. 2023 Feb. 1 [cited 2024 May 17];2(1):10–14. Available from: https://canadianeyecaretoday.com/article/view/2-1-2

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Volume 2, Issue 1, February 2023

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