Glaucoma Eye Drops and Dry Eye

Glaucoma eye drops lower pressure inside the eye to help protect the optic nerve. In some people, long-term treatment also contributes to dry eye, burning or a persistent gritty sensation. Reviewing these symptoms can improve comfort while maintaining effective glaucoma treatment.

Why irritation develops

The tear film coats the cornea, the clear front surface of the eye. It keeps this surface smooth for clear vision and helps protect it from irritation.

Some glaucoma drops contain preservatives that prevent microbial growth in the bottle. Repeated exposure can disturb the tear film and irritate the eye surface. The pressure-lowering medicine itself can also contribute to symptoms.

Ageing, eyelid inflammation and poorly functioning meibomian glands can add to the problem. These glands supply the oily component of tears that helps limit evaporation. More than one factor often needs attention.

What recent research shows

In a randomised study published in February 2026, people starting treatment for open-angle glaucoma received either preserved or preservative-free latanoprost. After three months, the preservative-free group had a more stable tear film and less corneal surface staining, a sign used to assess surface damage.

These findings support considering the formulation when reviewing treatment-related irritation. Changing the preservative alone will not address every cause of dry eye.

How our ophthalmologists can help

Our assessment includes the tear film, cornea, conjunctiva and eyelid glands. We also review which drops you use, how often you use them and when symptoms occur.

Dry eye treatment may include preservative-free lubricants and treatment for eyelid inflammation or blocked oil glands. Addressing these contributors may improve comfort without changing the glaucoma prescription.

Our clinic also offers intense pulsed light (IPL) treatment for suitable patients with dry eye associated with meibomian gland dysfunction. IPL can help improve tear-film stability and eye comfort when these eyelid oil glands are contributing to symptoms. Our ophthalmologists assess whether IPL is appropriate as part of your individual dry eye treatment plan, alongside ongoing glaucoma care.

If irritation persists, our ophthalmologists may consider a different glaucoma formulation or a suitable combination drop to simplify treatment. The choice depends on your target eye pressure, other medical conditions and previous response. Follow-up pressure measurements remain important after a change.

When to arrange a review

Persistent burning, grittiness, redness or fluctuating vision warrants review, particularly if discomfort makes it difficult to use your drops regularly. Bring your current bottles, including lubricants, so we can review the complete treatment plan.

Use your prescribed eye drops as directed. Contact our team before stopping or changing glaucoma treatment so that we can arrange a suitable plan. A painful red eye or sudden reduction in vision needs urgent same-day assessment.

At Eye and Retina Specialists Sydney in Green Square/Waterloo, our ophthalmologists Dr Neil Sharma, Dr Cheryl Au and Dr Linda Zheng provide glaucoma assessment and ongoing care, alongside management of dry eye and eyelid disease. If your glaucoma drops are causing ongoing discomfort, our team can assess the cause and discuss ways to make treatment more comfortable.