February 09, 2018
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Dry eye, PTSD, anxiety in glaucoma associated with decreased compliance

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Researchers encourage identifying and treating underlying ocular surface disease and anxiety disorders to increase adherence to glaucoma treatment.

Seventy-four U.S. veterans with glaucoma filled out a 63-question survey regarding dry eye symptoms, concurrent systemic disease and medications.

Fifty-nine patients (80%) reported compliance with glaucoma therapy and made up the complaint group. Compliance was defined as missing the medication less than 25% of the time, and missing 25% or more of the scheduled drops was considered “noncompliance.”

Researchers utilized the Dry Eye Questionnaire 5 (DEQ5) to confirm the presence and severity of ocular surface symptoms.

The population primarily consisted of males, and demographic factors such as gender, race and ethnicity were not found to affect compliance.

Twenty-nine patients (39%) reported mild or greater dry eye symptoms. These patients had reduced compliance with glaucoma medications compared with those without symptoms, researchers wrote. Seventeen patients (63%) with dry eye symptoms were compliant with medications vs. 89% of patients with no dry eye symptoms.

Researchers found no relationship between the total number of medications prescribed and compliance. The mean number of glaucoma medications in the patient population was 2.0, and the average number of systemic medications prescribed was 8.8.

Patients who claimed post-traumatic stress disorder (PTSD) and anxiety were more likely to complain of dry eye symptoms, researchers wrote.

Fifty-eight percent of patients with PTSD and 57% with anxiety complained of mild or greater dry eye symptoms, compared to 34% and 32% without PTSD or anxiety, respectively, according to researchers.

Patients receiving assistance using their drops had similar compliance to those who self-administered drops.

Forgetfulness was the most common factor mentioned as a barrier to compliance in this population but was not found to be associated with noncompliance.

Researchers stressed the importance of discussing treatment compliance with patients and collaboration with other medical providers, including mental health workers. – by Abigail Sutton

Disclosure: The authors report no relevant financial disclosures.