Topical Glaucoma Medications May Damage Lids

Doctor in face mask examining male patient
Mature doctor examining mid adult patient. Female healthcare worker is checking eyes of sick man.
Researchers noted elevated rates of lacrimal drainage obstruction and lid malposition among patients using glaucoma drops.

This article is part of Ophthalmology Advisor’s conference coverage from the 2021 meeting of the American Academy of Ophthalmology, held in New Orleans from November 12 to 15, 2021. The team at Ophthalmology Advisor will be reporting on a variety of the research presented by the ophthalmology experts at the AAO. Check back for more from the AAO 2021 Meeting.


Topical glaucoma medication use can increase the risk of developing lacrimal drainage obstruction (LDO) and lid malposition, according to research presented at the American Academy of Ophthalmology 2021 annual meeting, held November 12-15 in New Orleans.

The investigation examined records from 2002 to 2018 of patients older than 65 years who were being treated using topical glaucoma medications (n=122,582), as well as patients with glaucoma who were not using topical medications (n=232,336). Researchers compared the 2 groups’ risk of undergoing surgery for ocular adnexal disorders against a survival analysis of matched, propensity-rated cohorts. 

According to the investigators, the use of the topical glaucoma medication did increase lacrimal drainage obstruction (HR 1.22; 95% CI, 1.05-1.42), entropion (HR 1.24; 95% CI, 1.12-1.37) and trichiasis (HR 1.74; 95% CI, 1.57-1.94). However, the patients taking topical glaucoma meds did demonstrate a decreased risk of ectropion (HR 0.89; 95% CI, 0.81-0.97), with no altered risks of ptosis (HR 0.99; 95% CI, 0.89-1.09). 

“Medication-induced inflammation may mediate these associations,” the presenters speculated. “Awareness of the toxicity profile of topical glaucoma medications will allow more informed discussions around therapy options.”

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Quinn MP, Kratky V, Whitehead M, et al. Association of topical glaucoma medications with lacrimal drainage obstruction and eyelid malposition. Paper presented at: The American Academy of Ophthalmology 2021 Annual Meeting; November 12-15, 2021; New Orleans. Abstract P0214.