Issue 6/2026
Zaharinova, S., Vassileva, P.
Specialized hospital for active treatment “Acad. Pashev” – Sofia
Glaucoma is a chronic progressive disease and a leading cause of irreversible blindness, requiring long-term topical therapy. Although effective in lowering intraocular pressure, antiglaucoma treatment is frequently associated with ocular surface disease (OSD), particularly following prolonged use of benzalkonium chloride-preserved medications. Preservatives induce tear film instability, epithelial toxicity, and chronic inflammation of the ocular surface. Clinical manifestations include both subjective discomfort and objective ocular surface damage, leading to reduced treatment tolerability and poor therapeutic adherence. Contemporary management requires an individualized approach, including preservative-free formulations, fixed combinations, and regular ocular surface assessment to optimize therapeutic outcomes.
Address for correspondence:
Dr. S. Zaharinova
SOBAL „Acad. Pashev” – Sofia
Suhata Reka residential district,
51, „Emanuil Vaskidovich“, Str.
1517, Sofia