{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T08:18:07Z","timestamp":1770797887781,"version":"3.50.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,10,2]],"date-time":"2014-10-02T00:00:00Z","timestamp":1412208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Alcon Laboratories Australia Unrestricted Educational Grant"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Exper Ophthalmology"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Ocular surface disease (OSD<\/jats:styled-content>) is relatively common in glaucoma patients. OSD<\/jats:styled-content> symptoms could be linked to prolonged exposure to preservatives in anti\u2010glaucoma medications, especially benzalkonium chloride (BAK<\/jats:styled-content>). The OBSERVE<\/jats:styled-content> clinical audit was designed to track the impact of intraocular pressure lowering medications in patients with evidence of OSD<\/jats:styled-content> to test the hypothesis that BAK<\/jats:styled-content>\u2010free anti\u2010glaucoma preparations offer clinical advantages over BAK<\/jats:styled-content>\u2010containing products.<\/jats:p><\/jats:sec>Design<\/jats:title>Prospective clinical audit from M<\/jats:styled-content>arch 2012 to A<\/jats:styled-content>pril 2013, open to ophthalmologists practising in A<\/jats:styled-content>ustralia.<\/jats:p><\/jats:sec>Participants<\/jats:title>There were 375 patients enrolled, with a completion rate of 64%. The cohort was predominantly female (68%) with an average age of 71 years.<\/jats:p><\/jats:sec>Methods<\/jats:title>Patients were screened for inclusion during a routine consultation. If eligible, they were enrolled. At the ophthalmologist's discretion, some patients were switched to BAK<\/jats:styled-content>\u2010free anti\u2010glaucoma products. Data were collected via an online survey completed by the ophthalmologist during three appointments over a 16\u2010 to 30\u2010week period for all patients.<\/jats:p><\/jats:sec>Main Outcome Measures<\/jats:title>Intraocular pressure, tear\u2010film breakup time, M<\/jats:styled-content>cM<\/jats:styled-content>onnies D<\/jats:styled-content>ry E<\/jats:styled-content>ye Q<\/jats:styled-content>uestionnaire score and reported lubricant use.<\/jats:p><\/jats:sec>Results<\/jats:title>Patients who switched to BAK<\/jats:styled-content>\u2010free preparations reported a significant fall in the use of lubricants (P<\/jats:italic><\/jats:styled-content>\u2009=\u2009<0.001). Patients in both groups experienced a significant improvement in M<\/jats:styled-content>cM<\/jats:styled-content>onnies D<\/jats:styled-content>ry E<\/jats:styled-content>ye Q<\/jats:styled-content>uestionnaire score (P<\/jats:italic><\/jats:styled-content>\u2009=\u2009<0.0001). The percentage of patients with low tear\u2010film breakup time decreased significantly in both groups (P<\/jats:italic><\/jats:styled-content>\u2009=\u20090.0001). There was no significant change in intraocular pressure from pre\u2010study levels for either group (P<\/jats:italic><\/jats:styled-content>\u2009=\u20090.105).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>BAK<\/jats:styled-content>\u2010free anti\u2010glaucoma preparations were associated with a change in lubricant use, suggesting reduction in some OSD<\/jats:styled-content> symptoms, but more research is needed.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ceo.12431","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T07:06:02Z","timestamp":1409900762000},"page":"214-220","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Clinical audit examining the impact of benzalkonium chloride\u2010free anti\u2010glaucoma medications on patients with symptoms of ocular surface disease"],"prefix":"10.1111","volume":"43","author":[{"given":"Ivan","family":"Goldberg","sequence":"first","affiliation":[{"name":"Discipline of Ophthalmology University of Sydney Sydney New South Wales Australia"},{"name":"Glaucoma Unit Sydney Eye Hospital Sydney New South Wales Australia"},{"name":"Eye Associates Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stuart L","family":"Graham","sequence":"additional","affiliation":[{"name":"Discipline of Ophthalmology University of Sydney Sydney New South Wales Australia"},{"name":"Eye Associates Sydney New South Wales Australia"},{"name":"Australian School Advanced Medicine Macquarie University Sydney New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan G","family":"Crowston","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Melbourne Melbourne Victoria Australia"},{"name":"Centre for Eye Research Australia Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guy","family":"d'Mellow","sequence":"additional","affiliation":[{"name":"Terrace Eye Centre Brisbane Queensland Australia"},{"name":"Greenslopes Hospital Brisbane Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"Australian and New Zealand Glaucoma Interest 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