Dry eye illustration with a single tear drop falling.

Eye Drop Dilemma: Can Glaucoma Meds Damage Your Eyes?

Nico Varela in Health & Wellness December 2025 • 4 min read.

"A close look at how common glaucoma treatments affect ocular surface health and what it means for long-term eye care."

Glaucoma, a leading cause of blindness worldwide, often requires long-term treatment with topical hypotensive eye drops. While these medications effectively lower intraocular pressure, concerns have been raised about their potential impact on the ocular surface – the delicate outer layer of the eye.

Many patients using these drops report issues like dry eye, burning, stinging, and blurred vision. These symptoms might arise from the active drug itself or the preservatives added to prevent contamination. Understanding the specific effects of different glaucoma medications on the ocular surface is crucial for optimizing treatment and minimizing discomfort.

A recent study published in the Journal of Ophthalmology investigated the effects of various topical antiglaucoma drugs used as monotherapy on tear function and the ocular surface. This research offers valuable insights into how these medications may impact eye health.

Decoding the Impact: How Glaucoma Meds Affect Your Eyes

Dry eye illustration with a single tear drop falling.

The study, a prospective, randomized trial, included 85 eyes of 43 patients diagnosed with primary open-angle glaucoma who had not previously used topical medications. Participants were divided into six groups, each receiving a different medication:

Researchers then evaluated tear function (using Schirmer I test and tear film breakup time – TBUT) and ocular surface health (corneal and conjunctival staining) at the start of the study, after one week, and then at 1, 3, 6, and 12 months. Conjunctival impression cytology, a method to assess the cells of the conjunctiva, was performed at 3, 6, and 12 months to look for changes at the cellular level.

Group 1: Preservative-free timolol maleate (0.5%) twice daily
Group 2: Timolol maleate (0.5%) with benzododecinium bromide (BDD) twice daily
Group 3: Latanoprost (0.005%) with benzalkonium chloride (BAK) once daily at night
Group 4: Bimatoprost (0.03%) with BAK once daily at night
Group 5: Travoprost (0.004%) with BAK once daily at night
Group 6: Brimonidine (0.1%) with purite twice daily

The study revealed several key findings:

Protecting Your Vision: Key Takeaways for Glaucoma Patients

This study underscores the importance of considering the potential impact of glaucoma medications on the ocular surface. While all the tested medications effectively lowered intraocular pressure, some had more pronounced effects on tear function and ocular surface health.

If you're using glaucoma eye drops and experiencing discomfort, talk to your ophthalmologist. They can assess your ocular surface health and may consider switching medications, using preservative-free options, or adding lubricating eye drops to your treatment regimen.

Long-term management of glaucoma requires a delicate balance between controlling eye pressure and maintaining ocular surface health. Open communication with your eye doctor is key to finding the best approach for your individual needs.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1155/2014/460483, Alternate LINK

Title: The Effects Of Topical Antiglaucoma Drugs As Monotherapy On The Ocular Surface: A Prospective Study

Subject: Ophthalmology

Journal: Journal of Ophthalmology

Publisher: Hindawi Limited

Authors: Sevda Aydin Kurna, Semih Acikgoz, Ahmet Altun, Nurver Ozbay, Tomris Sengor, Osman Okan Olcaysu

Published: 2014-01-01

Everything You Need To Know

What are some potential side effects of using topical eye drops for glaucoma?

Topical hypotensive eye drops, commonly used to treat glaucoma by lowering intraocular pressure, can sometimes lead to side effects that affect the ocular surface. These side effects may include symptoms like dry eye, burning, stinging, and blurred vision. The impact can stem from either the active drug itself, or the preservatives added to the medication to prevent contamination. It's important to consider the ingredients in the drops to understand their impact.

Which glaucoma medications were specifically studied for their impact on eye health?

The *Journal of Ophthalmology* study mentioned several medications, including preservative-free timolol maleate, timolol maleate with benzododecinium bromide (BDD), latanoprost with benzalkonium chloride (BAK), bimatoprost with BAK, travoprost with BAK, and brimonidine with purite. The trial assessed how each of these impacts tear function and the ocular surface health, using tests like the Schirmer I test and tear film breakup time (TBUT), as well as corneal and conjunctival staining.

What are benzalkonium chloride (BAK) and benzododecinium bromide (BDD), and why are they relevant to glaucoma medications?

Benzalkonium chloride (BAK) and benzododecinium bromide (BDD) are preservatives commonly found in topical eye drops, including some glaucoma medications. These preservatives help prevent contamination, but they can also negatively impact the ocular surface. These can cause issues like dry eye, irritation, and damage to the cells of the conjunctiva. Preservative-free formulations, such as preservative-free timolol maleate, are available and may be a better option for some patients.

What tests were used to assess tear function and ocular surface health in the study?

The study in the *Journal of Ophthalmology* used methods such as the Schirmer I test and tear film breakup time (TBUT) to assess tear function. Corneal and conjunctival staining were used to evaluate ocular surface health. Additionally, conjunctival impression cytology was performed to analyze changes at the cellular level in the conjunctiva. These tests can help determine how different glaucoma medications affect the overall health and function of the eyes.

How was the Journal of Ophthalmology study designed to investigate the impact of glaucoma medications on eye health, and what are its implications?

The study's design, being a prospective, randomized trial, aimed to provide robust evidence on how different glaucoma medications affect the eyes. By including 85 eyes of 43 patients diagnosed with primary open-angle glaucoma who hadn't previously used topical medications, the research could compare the effects of various monotherapies directly. The study evaluated tear function and ocular surface health over a 12-month period. While informative, future studies might explore the long-term effects beyond 12 months and investigate combination therapies.