Ocular surface disease is characterized by tear film instability and histopathologic and clinical changes of
the ocular surface. Glaucoma patients often suffer from ocular surface disease caused by the chronic use of
preserved medical treatment to reduce intraocular pressure. Benzalkonium chloride is the preservative most
frequently used in glaucoma medications. Its effect on tear film, conjunctiva and cornea and the consequences in
glaucoma management are discussed in this mini-review.
Keywords: Glaucoma, preservative, benzalkonium chloride, ocular surface disease, corneal modification, tear film.
European Glaucoma Society. Terminology and Guidelines for glaucoma, 2014.
Champeau, E.; Edelhauser, H. Effect of ophthalmic preservatives on the ocular surface: conjunctival and corneal uptake and distribution of benzalkonium chloride and chlorhexidine digluconate., 1986.
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