Ocular Adnexal Changes After Antiglaucoma Medication Use.

Glaucoma is one of the leading causes of irreversible blindness worldwide, and the control of elevated intraocular pressure (IOP) requires medical treatment utilizing antiglaucomamedications (AGMs) that are the first line of treatment.1,2 However, there are some unwanted or adverse side effects of these AGMs on the ocular adnexa. Such effects include the development of periocular dermatitis, prostaglandin-associated orbitopathy, and eyelid malpositions.3 The etiology of eyelid changes and the inciting or underlying predisposing factors are unknown. Most AGMs that are applied to the ocular surface contain preservatives; however, preservative-free formulations are also available, and progressive ocular surface cicatricial changes have been observed after the use of preservative-free AGMs as well.4–6 In a few cases, extensive changes such as drug-induced cicatrizing conjunctivitis can simulate mucous membrane pemphigoid, which is visually debilitating and can be associated with trichiasis and cicatricial entropion.4 Clinicians need to be aware of these side effects because studies have shown that such side effects could negatively impact drug adherence and/or compliance.7 However, these side effects can be reversed by discontinuing the offending drug and changing to another class of drug, using preservative-free formulations, or switching to laser or surgical treatments, if detected early.8–10 This review summarizes the current knowledge about eyelid changes that develop secondary to chronic AGM use, excluding the effects on the ocular surface.