Insight flags preservative‑free drops benefit
- Insight published an April 25 explainer by Dr Jeremiah Lim and Lisa Jansen saying preserved glaucoma drops can worsen dry eye and ocular surface disease, and urging clinicians to consider preservative-free options. - The article says about 50% of glaucoma patients have comorbid ocular surface disease, and notes benzalkonium chloride is used in roughly 70% of ophthalmic formulations, adding to long-term drop burden. - The piece lands as Australian glaucoma care shifts toward reducing medication burden with laser and minimally invasive surgery as adherence and tolerance concerns gain weight. (insightnews.com.au)
Glaucoma drops lower eye pressure, but the preservatives in many bottles can also irritate the eye’s surface over time. (insightnews.com.au) Insight published an April 25 article by Dr Jeremiah Lim and Lisa Jansen arguing that preservative-free pressure-lowering drops and lubricants should be considered more often in glaucoma care. (insightnews.com.au) Their starting point is scale: about 50% of glaucoma patients experience ocular surface disease, and Australian research cited in the piece found dry-eye symptoms were more than twice as likely as in age-matched controls. (insightnews.com.au) The article points to benzalkonium chloride, or BAK, a common preservative used in about 70% of ophthalmic formulations. Repeated exposure can add to redness, irritation and discomfort in patients who may need drops for years. (insightnews.com.au) That matters in glaucoma because treatment only works if patients keep using it. Lim and Jansen frame comfort and adherence as linked problems, with preservative-free lubricants presented as a way to relieve dry eye without adding more preservative exposure. (insightnews.com.au) The piece also fits a broader shift in Australian glaucoma care away from lifelong drop burden where possible. Insight’s March 2024 industry update said selective laser trabeculoplasty is increasingly being used first-line, with nearly three-quarters of patients in LiGHT trial follow-up still medication-free after six years. (insightnews.com.au) Other recent Insight coverage has made the same point from the surgical side. A January 29 report on a Norwegian contralateral-eye study said iStent inject cut mean glaucoma medications from 1.9 to 0.4 at six months, a 79% reduction, while ocular surface measures improved. (insightnews.com.au) And in October 2025, glaucoma surgeon Brett Drury told Insight that ocular surface side effects from drops are “near-universal,” describing patients whose operated eye looked calmer than the fellow eye still treated with medication. (insightnews.com.au) The through-line in the new article is practical, not theoretical: if a patient needs chronic glaucoma therapy, the choice of bottle ingredients can shape whether the eye stays comfortable enough for long-term treatment. (insightnews.com.au)
