LIVING WELL

WITH GLAUCOMA
Elevating your treatment experience

Being diagnosed with glaucoma can be overwhelming.

However, support from family and small lifestyle changes
can help you live a fulfilling life. This booklet offers
practical tips to help ease your journey.

The English version of this booklet has been approved and

endorsed by the Asia-Pacific Glaucoma Society (APGS). The
localized version is a translation based on the English version.
 E
FP
TOZ Z
Z
Z
Practical lifestyle tips for better eye health Glaucoma management tips
Keep Up with
Regular Eye Exams
Stay Active for Address
Better Eye Health Sleep Apnea

Stay Active Keep Up with Regular Eye Exams

Regular exercise has been shown to have Regular appointments allow your doctor to monitor
neuroprotective benefits that can aid in glaucoma your situation and adjust treatment if necessary.8
management.1 Aim for at least 20 minutes of brisk
Practice Eyelid walking four times a week.1 If doing yoga exercises,
Hygiene avoid head-down postures which may increase eye
Ocular Surface Prostaglandin-Associated
pressure. 2 Apply Medications as Directed
Disease (OSD) Periorbitopathy Follow the medication timings as prescribed by your
Syndrome (PAPS)
doctor. Incorporate your eye drops into your daily
Z routine, such as after dinner or a bath. You can set
Z Watch your Diet
Z
reminders on your mobile or alarm clock. If you face
Green leafy vegetables and colored fruits are
challenges or side effects, discuss them with your
rich in antioxidants and may positively impact eye
doctor to explore alternatives.8
Address
health.3 In contrast, excessive caffeine intake (more
Sleep Apnea than 3 cups of coffee or tea per day) may cause a
Diet temporaryAvoid
increase in eye pressure.4,5
Smoking

TIPS For living well

with glaucoma

Z Address Sleep Apnea

Z
Z Sleep apnea is linked to a worsening of glaucoma. Be proactive about your
If you have sleep issues, speak to your doctor, as eye health.
Prostaglandin-Associated
this will form part of your glaucoma management.6
People with glaucoma can live
Periorbitopathy
Syndrome
Avoid (PAPS)
head-down
fulfilling lives without the fear of
poses blindness. Early detection, regular
follow-ups, and active participation in
Avoid Smoking Cigarettes your treatment and progress are key.8
Smoking is associated with higher eye pressure
and a faster progression of glaucoma.7

Avoid Smoking
Eye drops administration tips9-12

TIPS
Wash your hands For living well
thoroughly with with glaucoma
soap and water.
1 2

2 1 2 Wait Between Drops:

Shake the eye drop bottle If using multiple eye drops, wait at
or tube gently. least 5 minutes between different
medications to ensure proper
3
Tilt your head backward or absorption.9
1 2
lie on a bed. Look upward 3 4

and gently pull down Get Help if Needed:

your lower eyelid to form Don’t hesitate to ask family
a pocket. Instill the eye members to assist you with
drops into the pocket. applying eye drops if necessary.
4
4 6
Close your eyes and Missed Dose Protocol:
gently press on the
inner corner near your If you miss a dose, instill drops as
nose for 2 minutes. soon as you remember, unless it’s
almost time for your next scheduled
6 dose. In that case, skip the
Wipe excess liquid with a 5 missed dose.
tissue to decrease5
6

potential side effects on

the surrounding skin.
Contact Lenses:
Remove contact lenses before
For bottle medication: instilling glaucoma medications
6 Recap after use and and wait 15-20 minutes before
do not wash the tip. reinserting.11,12
For preservative-free
medication: Dispose the
used tube according to the
drug usage instructions.
What is the role of eye drops in Ocular surface disease (OSD) and
glaucoma treatment? preservative damage

Glaucoma eye drops are crucial for lowering eye pressure and Glaucoma medications, particularly those with preservatives are known
preserving vision.13 Fortunately, the wide range of treatment options to increase the risk of OSD.14,15
make glaucoma manageable. It is important to discuss glaucoma
management options with your doctor, to determine which Symptoms of OSD includes:17
medications or other treatment options best fit your lifestyle.

What are the potential side effects?

Some glaucoma medications can cause side effects such as ocular
surface disease, cosmetic changes around the eyes, and temporary DRYNESS REDNESS DISCOMFORT
blurring of vision.13,14 In the following section, we will discuss two Dryness Redness Discomfort
common side effects and how best to manage them.
How can a treatment with less
preservatives help?
Preservatives are commonly used in glaucoma medications to prevent
bacteria from
DEEPgrowing
UPPER in the bottle. But higherEXCESSIVE
DARKENING concentrations
EYELASH of
EYELID GROOVE GROWTH
preservatives can cause dry eye and irritation, especially with
Prostaglandin-associated long-term use.17 If you have OSD or are at high risk of it, formulas with
Ocular surface disease
periorbitopathy syndrome low-preservative concentration or entirely preservative-free eye
(OSD)
(PAPS) drops may be a better option.
What is it? DROOPING UPPER

TIPS
EYELID
For living well
A condition characterized A range of visible changes
with glaucoma
by alterations to the eye around the eyes caused by
surface, leading to prostaglandin analogues
discomfort and dry eye.15 (PGAs) glaucoma eye drops
Discuss low preservative
concentration or preservative-free
How common is it? glaucoma eye drop with your doctor.

~50 % ~50 %
If you are experiencing eye redness and
discomfort from your eye drops, it is important
of glaucoma patients of PGAs users to discuss this with your eye doctor.
have OSD14 develop PAPS16
 Prostaglandin-associated periorbitopathy
syndrome (PAPS) and its impact
DRYNESS REDNESS DISCOMFORT

PAPS refers to a collection of visible changes around the eyes How can switching treatments help?
associated with the use of prostaglandin analogues (PGAs) such
Your doctor may have prescribed a PGA because they are a reliable
as tafluprost, latanoprost, bimatoprost, and travoprost. While the exact
and effective option for managing glaucoma.17,18
cause of PAPS is not fully understood, it is believed that eye drops are
absorbed by both the eye and surrounding tissue, leading to various However, if you have concerns about PAPS, don’t hesitate to reach out
symptoms: 16,17 to your doctor; there are options to adjust your treatment plan to
DEEP UPPER DARKENING
DRYNESS EXCESSIVE EYELASH
REDNESS DISCOMFORT
EYELID GROOVE GROWTH better suit your needs.

DRYNESS REDNESS DISCOMFORT

TIPS For living well
with glaucoma

DROOPING UPPER
EYELID
DEEP UPPER DARKENING EXCESSIVE EYELASH
Be mindful when
EYELID GROOVE
Deepening of the Darkening
GROWTH applying PGA
REDNESS upper eyelid groove
DISCOMFORT around the eyes eye drops.
DEEP UPPER DARKENING EXCESSIVE EYELASH If you are using a PGA, wipe excess drops
EYELID GROOVE GROWTH
with a tissue after administration to reduce
medication side effects and potential skin
DROOPING UPPER color changes around the eye.
EYELID

DARKENING EXCESSIVE EYELASH

Discuss alternative
GROWTH
DROOPING UPPER
EYELID
treatment options
Excessive Drooping with your doctor.
eyelash growth of upper eyelid
If you are experiencing PAPS or have
concerns about it, discuss it with your
These cosmetic changes may impact a person’s appearance and
eye doctor.
self-perception, potentially affecting treatment adherence.
OOPING UPPER
Additionally, PAPS can cause tight eyelids, which can hinder
EYELID
accurate eye pressure readings and affect the outcomes of
future glaucoma surgeries.
Ocular surface disease checklist*19 Prostaglandin-associated periorbitopathy
Please answer the following questions by checking the box that best represents your syndrome (PAPS) checklist20
answer. Select only one answer per question.
Please answer the following questions by checking the box that best represents your
1. Report the type of SYMPTOMS you experience and when they occur: answer. Select all that apply.

At this visit Within past 72 hours Within past 3 months Are you noticing any of the following symptoms?
Symptoms Yes No Yes No Yes No
Dryness, Grittiness or
Scratchiness

Soreness or Irritation

Burning or Watering
Exessive eyelash growth Darkening around the eyes

Eye Fatigue

2. Report the FREQUENCY of your symptoms using the rating list below:
Symptoms Never Sometimes Often Constant
Dryness, Grittiness or
Scratchiness

Soreness or Irritation
Fat loss around the eye Deepening of the upper eyelid groove
Burning or Watering

Eye Fatigue
Do you have any concerns about changes in your eyes or the surrounding area?
(e.g., dark circles, eyelid changes, or redness)
3. Report the SEVERITY of your symptoms using the rating list below:
No Slight Moderate Strong Very strong
Symptoms No Problems Tolerable Uncomfortable Bothersome Intolerable concern concern concern concern concern
Dryness, Grittiness or
Scratchiness

Soreness or Irritation
If you were to face these changes, what impact would they have on your
Burning or Watering daily life?

Eye Fatigue No Slight Moderate Strong Very strong

impact impact impact impact impact

4. Do you use eye drops for lubrication?

Yes No If yes, how often?

If you notice any PAPS symptoms around your eye(s) or are concerned that these changes
might affect your quality of life, please discuss your concerns with doctor proactively.
*Adapted from the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire.It is one
tool we use to help assess your dry eye symptoms and does not rule out a clinical diagnosis Images provided by Dr. Chien-Chia Su (Taiwan), Dr. Grace D. Grozman (Philippine),
of dry eye. 0-4 you are experiencing MILD dry eye symptoms. 5-7 you are experiencing Prof. Makoto Aihara (Japan) and Dr. Yanin Suwan (Thailand). All images were granted
MODERATE dry eye symptoms. 8+ you are experiencing SEVERE dry eye symptoms. permission for use, and informed consent was obtained from the patients.
YOU CAN LIVE WELL WITH GLAUCOMA

We hope this booklet provides you the knowledge and confidence to manage your
glaucoma, so you can continue living a fulfilling daily life. If you have questions
or concerns, speak to your doctor. Treatment plans should be individualized and
your doctor is best suited to give you the right guidance.

Disclaimer: This booklet is intended only for patients diagnosed with glaucoma and should be distributed by
healthcare professionals. The contents are for educational purposes only.

Acknowledgment: This patient education booklet was developed in collaboration with leading glaucoma
experts. We extend our special thanks to Prof. Vijaya Lingam (India), Chair of the APGS Patient Education
Review Committee, Assoc. Prof. Poemen Chan (Hong Kong), Dr. Sujatha V. Kadambi (India), and Assoc.
Prof. Victor Koh (Singapore) for their valuable contributions as members of the APGS Patient Material
Review Committee.

References: 1. Glaucoma Research Foundation. Aerobic Exercise for Neuroprotection. Available at: https://glaucoma.org/articles/
aerobic-exercise-for-neuroprotection. Accessed November 2024 2. Glaucoma Research Foundation. Is doing Yoga Safe If I have
Glaucoma. Available at: https://glaucoma.org/articles/is-doing-yoga-safe-if-i-have-glaucoma. Accessed January 2025. 3. Glaucoma
Research Foundation. How to Lower Intraocular Eye Pressure. Available at: https://glaucoma.org/articles/how-to-lower-intraocular-
eye-pressure. Accessed January 2025. 4. Glaucoma Australia. Lifestyle, Diet and Exercise. Available at: https://glaucoma.org.
au/i-have-glaucoma/living-with-glaucoma/lifestyle-diet-and-exercise. Accessed January 2025. 5. Avisar R, et al. Effect of Coffee
Consumption on Intraocular Pressure. Annals of Pharmacotherapy. 2002;36(6):992-995. 6. American Academy of Ophthalmology.
Sleep Apnea and Glaucoma. Available at: https://www.aao.org/eye-health/tips-prevention/obstructive-sleep-apnea-glaucoma.
Accessed November 2024. 7. Glaucoma Research Foundation. Exercise, Diet and Other Lifestyle Changes for People Living with
Glaucoma. Available at: https://glaucoma.org/articles/exercise-diet-and-other-lifestyle-changes-for-people-living-with-glaucoma.
Accessed January 2025. 8. Glaucoma Research Foundation. Living Well with Glaucoma. Available at: https://glaucoma.org/
understanding-glaucoma/life-with-glaucoma. Accessed November 2024. 9. National Eye Institute. How to put in Eye Drops. Available
at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/glaucoma-medicines/how-put-eye-
drops. Accessed January 2025. 10. Glaucoma Research Foundation. Is There A Best Technique For Putting In Eye Drops? Available
at: https://glaucoma.org/articles/is-there-a-best-technique-for-putting-in-eye-drops. Accessed January 2025. 11. Vision Eye Institute.
Why is it important to use your eye drops correctly. Available at: https://visioneyeinstitute.com.au/eyematters/why-its-important-to-
use-your-eye-drops-correctly/#:~:text=Also%2C%20make%20sure%20to%20wipe%20away%20any%20excess,the%20eye%20
may%20contaminate%20the%20eye%20drop%20solution. Accessed January 2025. 12. Glaucoma Australia. Do’s and Don’ts of
Glaucoma Eye Drops. Available at: https://glaucoma.org.au/news-details/news/dos-and-donts-of-glaucoma-eye-drops. Accessed
January 2025. 13. American Academy of Ophthalmology. What is Glaucoma? Available at: https://www.aao.org/eye-health/
diseases/what-is-glaucoma. Accessed November 2024. 14. Boso ALM, et al. Clin Ophthalmol 2020:14 103–11. 15. Sarimiye TF, et
al. JOECSA 2015; 15(01). Retrieved from https://joecsa.coecsa.org/index.php/joecsa/article/view/236. 16. Tanito M et al. Medicine
2021;100:34(e26874). 17. Radcliffe NM, et al. Ophthalmol Ther 2023;12:2823–39. 18. Weinreb RN, et al. JAMA 2014;311(18):1901–11.
19. SPEED Questionnaire. Available at: https://www.reviewofoptometry.com/cmsdocuments/2022/05/speed-questionnaire.pdf.
Accessed November 2024. 20. Santen Pharmaceutical Asia Pte. Ltd. PAPS Guidebook. 2022.

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Santen Pharmaceutical Asia Pte. Ltd., 6 Temasek Boulevard #37-01,
Suntec Tower Four, 038986, Singapore. Office: +65 6715 7800.
Date of preparation: January 2025. NP-GLAU-Asia-0055.