The effect of 0.5 percentage Carboxymethylcellulose on corneal thickness in glaucoma and non glaucoma patients a stratified randomised control trial

Glaucoma is a leading cause of blindness prevailing in the world. In the United States, glaucoma is the second leading cause of blindness and it is the most frequent cause of blindness among African -Americans.. It was estimated that 12 million Indians would have  been affected by 2020. Epidemiological studies on glaucoma involving adults age 40 years and above have estimated glaucoma prevalence between 2.7 and 4.3% among indians. The goal of treatment of glaucoma is to lower the rate of progression throughout a patient’s lifetime in order to maintain visual function and related quality of life. Elevation of Intraocular pressure remains as a treatable risk factor and is known to be associated with the progression of glaucoma

A long-term therapy with topical intraocular pressure lowering agents is usually necessary to preserve the visual field and thus patients’ quality of life. Most of the patients with glaucoma require long term or lifelong use of eye drops which is associated with ocular surface diseases and thinning of cornea. Topical antiglaucoma medications depending on the class, could cause thinning, thickening or no change to the CCT.

Ocular Lubricants when used is found to cause an increase in the central corneal thickness often after 2 weeks to one month of therapy in dry eye from the base line. This study is designed to investigate the effect of lubricants (0.5% carboxymethylcellulose -CMC- which is used as artificial tears in opd regularly and harmless with no side effects reposted as of now) on the central and peripheral corneal thickness and epithelial thickness in the glaucoma patients and non-glaucoma subjects.it is found to be beneficial it will  become a boon the glaucoma patients with corneal thinning.

• There are very few studies that have actually studied the CCT and mid PCT of glaucoma and non-glaucoma patients. Here we determine the CCT and mid PCT of glaucoma and non-glaucoma patients with and without carboxy methylcellulose. We determine the changes in the 3 zones of CET and CCT -namely central zone (0-2mm), paracentral zone (2-5 mm) and mid peripheral zone (5-7mm).
• None of studies have got any relevant information about a ratio between central epithelial to central corneal thickness. In this study, we try to assess if there is any difference in CET to CCT ratio among glaucoma and non-glaucoma patients with and without lubricants.
• If we can prove by the study that there is an increase in CCT and mid PCT with the use of lubricants in glaucoma patients, instilling lubricants along with antiglaucoma medications will improve the corneal thickness from the baseline and thus patients’ quality of life.

Hence the study becomes significant.