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    Dry eye gains importance in glaucoma care

    New treatments and greater awareness are making dry eye an even more important part of glaucoma care, according to Richard Lewis, MD, of Sacramento Eye Consultants.

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    “The treatment has really improved,” said Dr. Lewis at the 21st annual Glaucoma Symposium during the Glaucoma 360 meeting. He cited lifitegrast (Xiidra, Shire), which gained FDA approval in July 2016, and an experimental new nasal nerve stimulator (TrueTear, Allergan), whose new drug application is now under FDA consideration.

    Awareness of dry eye is increasing, partly as a result of a campaign Shire has launched featuring advertisements with actress Jennifer Aniston, he noted.

    Related: How OCT innovations are changing glaucoma care

    “People are coming out of the woodwork now with dry eye,” Dr. Lewis said.

    As a result, glaucoma specialists must pay more attention to the condition.

    “Not many people in glaucoma want to talk about dry eye,” he said. “We all have patients, and we wish they would go elsewhere. But they’re not going elsewhere.”

    Depending on the definition of the condition, estimates of the prevalence range from 7.8% for 48.0%, but Dr. Lewis considers the Beaver Dam study figure of 14.4% closest to the reality.

    And even some patients who don’t have the condition when they begin glaucoma treatment end up with dry eyes as a reaction to glaucoma medications.

    “There is no one better than myself for creating dry eye with some of the drops I use,” Dr. Lewis said.

    More: Introducing 3-D OCT to live surgery

    Alpha agonists in particular can elicit follicular conjunctivitis, he pointed out.

    And nearly 60% of medically treated glaucoma patients report ocular surface disease, he said.

    Complicating glaucoma

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