How Similar Are Changes to the Surface of the Eye When Two Different Glaucoma Eye Drops Are Used?

• Conjunctival hyperemia [ Time Frame: 2 months ] [ Designated as safety issue: No ]
  Redness grading of the conjunctiva on a scale from 0 to 3 (none, mild, moderate and severe).
• ocular surface disease index questionnaire [ Time Frame: 2 months ] [ Designated as safety issue: No ]
  Patient answers 12 questions regarding eye comfort under different conditions/environments.
• impression cytology [ Time Frame: 2 months ] [ Designated as safety issue: No ]
  Looking for inflammatory cells in 4 quadrants on the conjunctiva
• staining [ Time Frame: 2 months ] [ Designated as safety issue: No ]
  corneal staining with fluorescein and conjunctival staining with lissamine green

The purpose of this research study is to determine whether one glaucoma eye drop is less likely to cause changes to the surface of the eye (conjunctiva) than another. The investigators plan to determine this theory by comparing the results when a patient is using two different prostaglandins, Xalatan and Travatan Z. (Both of these drops are presently on the market and are approved by the FDA for the treatment of eye pressure). Because this study will be masked, the clinician who reviews the study results will not know what study drop each patient has been using.

Two groups will be entered into this study: group 1 will be naive to treatment and group 2 will be using Xalatan for at least one month. Both groups will be using one drop at bedtime of Xalatan in the right eye and one drop at bedtime of Travatan Z in the left eye.

• Drug: Xalatan
  one drop of Xalatan Ophthalmic Solution instilled in right eye at bedtime
  Other Name: prostaglandin analog
• Drug: Travatan Z
  one drop of Travatan Z Ophthalmic Solution instilled in left eye at bedtime
  Other Name: prostaglandin analog

• New to Meds
  Naive to glaucoma therapy medical or surgical. All patients will receive Xalatan in the right eye and Travatan Z in the left eye.
  Interventions:

  • Drug: Xalatan
  • Drug: Travatan Z
• Currently on Xalatan
  Patients currently on Xalatan at least one month. All patients will receive Xalatan in the right eye and Travatan Z in the left eye.
  Interventions:

  • Drug: Xalatan
  • Drug: Travatan Z

Inclusion Criteria:

• Age 21 or older
• Able to understand protocol and agree to 3 visits
• Any type of glaucoma
• SLT, ALT, PI accepted
• Naïve: No prior glaucoma treatment (medical or surgical)
• If pt non-compliant, must be off meds 3 months
• Xalatan: At least one month use

Exclusion Criteria:

• Both Groups: Any history of ocular surface disease
• Dry eye syndrome or prior Restasis use
• Prior ocular surgery other than cataract extractions
• Uveitis or other inflammatory disease of the eye or adnexa
• Systemic medications that might influence ocular inflammation
• Any active inflammation or infection
• Pregnancy or intention to become pregnant
• Naïve: Prior use of topical glaucoma med unless off for 3 months.
• Use of preserved artificial tear preparations in last 30 days and more than one year history of chronic use
• Xalatan: Prior use of Travatan or Travatan Z