CONJUNCTIVAL CHANGES ASSOCIATED WITH GLAUCOMA THERAPY - IMPLICATIONS FOR THE EXTERNAL DISEASE CONSULTANT AND THE TREATMENT OF GLAUCOMA

Purpose. Enhance recognition by the external disease specialist of the conjunctival changes associated with glaucoma therapy and the reporte d association with glaucoma filtration surgery. Methods. Literature se arch with emphasis on the cellular and subcellular changes induced by antiglaucoma medications, the definition and diagnosis of drug-induced cicatricial conjunctivitis (DICC), and the implications for future gl aucoma therapy or surgery. Results. Significant conjunctival and subco njunctival changes occur associated with the use of antiglaucoma medic ations that affect the success of glaucoma filtration surgery. The ext reme form of change is the DICC, which is clinically and pathologicall y identical to ocular cicatricial pemphigoid. The autoantigen in the b asement membrane probably differs in these two disease processes. Conc lusions. There is a movement toward an earlier approach to glaucoma fi ltration surgery, in large part based on the literature reviewed here. The external disease specialist needs to be cognizant of these conjun ctival changes to best consult on patients receiving antiglaucoma medi cations.