Clinical Scorecard: Fighting BAK

At a Glance

Key Highlights

• Glaucoma patients have a higher prevalence of OSD than the general population.
• BAK is the primary cause of OSD in glaucoma patients due to its damaging effects on conjunctival goblet cells.
• Preservative-free drops and alternative therapies can improve patient quality of life.
• Regular screening for dry eye symptoms is essential in glaucoma care.
• Minimally invasive procedures can reduce the need for topical drops.

Guideline-Based Recommendations

Diagnosis

• Screen glaucoma patients for ocular surface symptoms using questionnaires.

Management

• Start with artificial tears and assess for blepharitis or meibomian gland dysfunction.
• Consider laser trabeculoplasty or BAK-free medications to reduce drop burden.

Monitoring & Follow-up

• Regularly evaluate the effectiveness of artificial tears and other treatments.

Risks

• Prolonged exposure to BAK can cause permanent damage to conjunctival goblet cells.

Patient & Prescribing Data

Glaucoma patients experiencing ocular surface symptoms.

Preservative-free options like tafluprost and preservative-free dorzolamide-timolol are now available.

Clinical Best Practices

• Reduce BAK exposure by choosing preservative-free drops.
• Involve specialists from cornea or oculoplastics when necessary.
• Utilize compounding pharmacies for personalized preservative-free drop options.

References

• Saeedi, O. J. (2023). Fighting BAK.