Impression cytology was used to compare the morphological changes seen in glaucoma patients with topical therapy with those, found in typical eye patients. Classifying the changes with the IC-Score glaucoma patients showed changes not exceeding a minimal to moderate pathological picture, compared with dry eye patients. We therefore conclude that the superficial tissue of the ocular surface always responds to the same pattern regardless of the actual cause. On the other hand there seems to be an association between causation and the degree of severity of the changes. Therefore, glaucoma patients should be carefully examined before prescribing therapy, preservative-free medication should be preferred, patients should be closely followed-up and each underlying disease should be treated.
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