5d • General discussion
When Glaucoma Drops Become the Problem
This patient developed significant redness, irritation and ocular surface inflammation while using topical glaucoma medication.
At first glance, this may seem like a common ocular surface issue. However, persistent redness and irritation should prompt us to consider allergy or intolerance to the glaucoma drops themselves.
In this case, the eyes cleared significantly after all topical glaucoma drops were stopped. No topical anti-inflammatory treatment was required. During this period, the IOP was managed with oral Diamox (acetazolamide) while the ocular surface recovered.
Once the suspected medication-related reaction was identified, treatment options could be reassessed. Topical drops can be reintroduced cautiously, one at a time, to identify the offending agent, or SLT can be considered to reduce the need for topical medication.
The patient was managed by Dr Ashvira Moodley and has also undergone selective laser trabeculoplasty (SLT).
Key takeaway:
When a glaucoma patient develops persistent ocular surface inflammation, consider whether the treatment itself may be contributing to the problem. Stopping the offending drops, maintaining IOP control and then individualising further treatment can help protect both ocular surface health and long-term glaucoma control.
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When Glaucoma Drops Become the Problem
