Barriers to Glaucoma Medication Compliance Among Veterans: Dry Eye Symptoms and Anxiety Disorders.

Objective: To identify barriers to compliance of medical treatment for glaucoma among veterans.

Methods: Patients with glaucoma from the Miami Veterans Affairs Eye Clinic (n=74) filled out a 63-question survey regarding dry eye symptoms, concurrent systemic disease, and medications. The association between glaucoma medical compliance was defined as self-reported adherence to drop regimens greater than 75% of the time.

Results: Eighty percent of veterans (n=59) reported compliance with glaucoma therapy. Dry eye symptoms (as defined by Dry Eye Questionnaire 5 score ≥6) were reported by 39% (n=29), and their presence was associated with decreased compliance (63% vs. 89%, P=0.007). Anxiety and posttraumatic stress syndrome (PTSD) were also associated with significant noncompliance (64% vs. 83%, P=0.05 and 58% vs. 84%, P=0.02, respectively). Other studied factors including demographics, depression (P=0.11), and glaucoma regimens did not play a significant role in glaucoma medication compliance.

Conclusions: Dry eye symptoms, PTSD, and anxiety were associated with decreased compliance to medical treatment of glaucoma. Identifying and treating underlying ocular surface disease and anxiety disorders may lead to increased adherence to glaucoma treatment.