Effectiveness of Topical 0.05 percent Cyclosporine in ocular surface disease among long term Antiglaucoma drugs users

This is a Hospital based Prospective Comparative study , in which 150 glaucoma patients on 2 or more topical antiglaucoma medication ( beta blocker + alpha 2 adrenergic agonist ) with or without prostaglandin analogue at least for 6 months will be recruited from OPD basis . Patients will be recruited after matching all inclusion and exclusion criteria and those who are willing to participate in study . Patients will be divided in 2 groups 1 group will be given topical cyclosporine 0.0.05 % along with topical antiglaucoma medication and other group will be given topical sodium hyaluronate 0.01% along with topical antiglaucoma medication.  Results will be compared in 8 outcome variables BCVA ( best corrected visual acuity), IOP ( intraocular pressure) , OSDI ( OCULAR SURFACE DISEASE INDEX), Schirmer test, TBUT ( Tear film break up time) , Conjunctival impression cytology by Nelson grading,  Corneal staining,  Tear film height . Outcome variables will be measured at time of recruitment for both cases and control and again at 8wk follow up. Then effectiveness of topical cyclosporine 0.05%  will be compared to topical sodium hyaluronate 0.01% after completion of follow up at 8 weeks .