Barriers to Glaucoma Medication Compliance Among Veterans: Dry Eye Symptoms and Anxiety Disorders

Saturday, April 18, 2015: 4:06 PM
Room 1B (San Diego Convention Center)
Jack Stringham, MD
Noy Ashkenazy, MS
Anat Galor, MD, MSPH
Sarah R. Wellik, MD

To identify barriers to medical glaucoma compliance among veterans.

Glaucoma patients from the Miami Veterans Affairs Eye Clinic (n=74) filled out a 63 question survey regarding dry eye symptoms (Dry Eye Questionnaire 5 (DEQ5)), concurrent systemic disease, and medications which were evaluated in conjunction with glaucoma medical compliance. Compliance was defined as self-reported adherence to drop regimens >75% of the time. 

Seventy nine percent of veterans (n=56) reported  compliance with medical glaucoma therapy. Mild dry eye symptoms (DEQ5≥6) were reported by 38% (n=29) and their presence was associated with decreased compliance (63% vs 89%, p=0.007). An anxiety or posttraumatic stress syndrome (PTSD) diagnosis were also associated with significant noncompliance, (64% vs 83%,p= 0.048 and 58% vs 84%, p=0.016, respectively). Other studied factors including demographics, depression (p=0.11), and glaucoma regimens did not play a significant role in glaucoma medication compliance.

Patients with dry eye symptoms, PTSD, or anxiety are at increased risk of topical glaucoma noncompliance. Identifying and treating underlying ocular surface disease and anxiety disorders may lead to increased glaucoma treatment compliance.