Anti glaucoma medications are the fix, but not without a down side

The use of anti glaucoma medications over long periods of time will impact the overall health of the eye in other ways. The most significant is OSD, or Ocular Surface Disease. Mostly this is called Dry Eye, and is a very uncomfortable and damaging problem that needs to be managed alongside the glaucoma treatments.

Excellent resource for this aspect of eye treatments is here:
https://eyesoneyecare.com/resources/glaucoma-impact-on-ocular-surface/

OSD is more likely to occur and be more severe when multiple anti-glaucomatous medications are needed to control the IOP and used over a long period of time. Given that most glaucoma sufferers have the contidion for many years, the problem of OSD is very common. Not only is this because of the extended and repeated exposure to the medications but also because all medications contain preservatives.

The use of drops with preservatives over a long period can increase ocular surface inflammation, damage corneal and conjunctival tissue, and other issues. Doctors struggle with this problem with their patients because the discomfort that is caused often makes patients then reluctant to remain compliant with the primary medication regime, obviously a danger to their long term condition.

Artificial tears without preservative, a great relief

Treatment generally is to apply artificial tears, essentially a saline solution with other additives, to maintain the fluidity of the eye surface and counteract the dry eye syndrome. Previously though, choosing caution to guard against eye infections, artificial tears also contained preservatives. Now there are preservative-free eye artificial tears which can reduce the potential detrimental effect on the eye and has been shown to improve signs and symptoms of dry eye disease.

In order to ensure sterility of the artificial tears without using a preservative, the solution is packaged into small soft plastic vials that are sealed. These contain about enough for one application and you break open the seal and apply the solution to the eye immediately. I have one that is a little more useful for me, the vial is slightly larger and the cap breaks off but can be clipped back on so that one vial if stored carefully can be enough to be used several times during one day.

See here for the full discussion about artificial tears for the many types and studies into what works and provides good background for a patient's general education about their condition:

https://eyesoneyecare.com/resources/a-comparative-list-of-all-artificial-tears-with-download/#pf-ats

My dry eye troubles over the years

I have had times when dry eye was a big problem and made my eyes very sensitive to even slight air movements, noticable when sitting near a fan or air conditioner. In the car particularly caused this problem. This was always when I was needing to use multiple medications in an attempt to reduce my IOP which generally was a losing battle ending in surgery. Surgery is traumatic in the short term, but my experience has been that the liberation from the medications cycle is wonderful and I have had periods of years at a time of "normal" eye health. I say normal, but not normal, only that a trebeculectomy procedure has allowed a vent in my eye which releases the pressure when an attack is happening, thereby taking the place of the medication.

My Cataract Surgery

My right eye developed a signigicant cataract, ultimately needing to have the cornea replaced in 2015. No eye surgery is easy but of everything that I have endured, the cornea replacement was simple (as eye surgery goes) and the recovery time was not prolonged, and the results quickly appreciated and absolutely worth the suffering and cost to get done.

My left eye however has not required cataract surgery becasue for the worst of the condition over all the years, it has been confined to my right eye. My left eye was normal up till the relapse that will be the subject of the next post.