A study on the clinicocytolological analysis of the conjunctiva of patients on topical anti glaucoma medications

Abstract

ABSTRACT newlineBackground: Glaucoma is a prevalent cause of visual impairment. Glaucoma is the main risk factor of permanent blindness in India. Glaucoma has many therapeutic as well histological manifestations. The application of anti-glaucoma medications over an extended period and without discrimination may come in various harmful consequences on tissues, despite the initially positive outcome of effectively managing the pressure inside the eye. Eventually, these medications become ineffective and need perhaps laser or surgical therapies. Recent research suggests that prolonged use of drugs applied externally might cause alterations in the mucosa and ocular surface, thereby impeding future ab externo filtering procedure that the patient may need. We utilized the method of conjunctive impressions cytology to assess the alterations in the cornea that occur as a result of prolonged application of antiglaucoma drugs via application to the skin. Research carried out on individuals who have used applied topically antiglaucoma drugs for an extended period of time has revealed an elevated presence of fibroblasts and inflammation cells in the conjunctival substantia propria. Additionally, there is a reduction in the amount of epithelium goblet cells and the occurrence of epithelial metaplasia accompanied by fundamental alterations. A study conducted on persons that have taken topically administered antiglaucoma medicines for a long duration has shown a higher concentration of fibroblasts and lymphocytes in the conjunctival substantia propria. Furthermore, there is a decrease in the quantity of epidermal tissue cells in goblets and the presence of epithelial metaplasia followed by significant changes. newlineMaterials and Methods: An 18-month prospective qualitative investigation was done to evaluate cytological alterations. The evaluation was carried out for patients who were receiving long-term antiglaucoma medication and their cytological newlinecorrelation. This was achieved from evaluating the conjunctival impression smears which was graded via using standard Nelson s Grading system. newlineResults: Of the 65 patients who were using topical antiglaucoma medications were evaluated from conjunctival impression smears. From the Nelson s Grading system presented to showcase significant association with Group I and II of the study population exhibited higher grades from the cytological observation using the grading system. Predominant cases of Group I were showcasing significant impact or cytological alterations in the conjunctiva and ocular surface among the study groups when compared with the control. newlineConclusion: This study firmly concluded the previous literature studies showcasing the downside with the usage of IOP lowering ophthalmic solutions. A better management and treatment plan should be adopted to tackle this complication. newlineKey words: AT, NCT, CCT, Nelson Grading System, conjunctival impression cytology newline