Purpose: To investigate the relationship between glaucoma, pseudoexfoliation and hearing loss (HL). Methods: A systematic literature search following PRISMA guidelines was conducted using the PubMed, Embase, Scopus and Cochrane databases from 1995 up to 28 August 2023. Results: Thirty studies out of the 520 records screened met the inclusion criteria and were included. Most articles (n = 20) analysed the association between pseudoexfoliation syndrome (XFS) and HL, showing XFS patients to have higher prevalence of sensorineural hearing loss (SNHL) at both speech frequencies (0.25, 0.5, 1 and 2 kHz), and higher frequencies (4 and 8 kHz) compared to controls in most cases. No significant differences in prevalence or level of HL between XFS and pseudoexfoliative glaucoma (XFG) were detected in most studies. Eight articles analysed the relationship between primary open-angle glaucoma (POAG) and HL. Overall, a positive association between the two conditions was highlighted across all studies except for two cases. Similarly, articles focusing on NTG and HL (n = 4) showed a positive association in most cases. The role of autoimmunity and, in particular, the presence of antiphosphatidylserine antibodies (APSA) in patients with NTG and HL suggested an underlying autoimmune or vascular mechanism contributing to their pathogenesis. Only one study analysed the relationship between angle-closure glaucoma (ACG) and HL, showing higher incidence of ACG in patients with SNHL compared to normal hearing controls. Conclusions: Most studies detected an association between XFS and HL as well as POAG/NTG/ACG and HL, suggesting the presence of a similar pathophysiology of neurodegeneration. However, given the strength of the association of XFS with HL, it remains unclear whether the presence of XFG is further associated with SNHL. Further research specifically targeted to assess the correlation between glaucoma, XFS and HL is warranted to provide a more comprehensive understanding of this association.

Objective: To evaluate the efficacy of lid wipes and tear substitutes, in addition to standard postoperative treatment, in alleviating signs and symptoms of ocular surface disease (OSD) following cataract surgery. Methods: Retrospective study on patients who underwent cataract surgery and received either standard postoperative treatment (topical antibiotics, corticosteroids, and nonsteroidal anti-inflammatory drugs) or the same regimen supplemented with lid wipes and tear substitutes. Preoperatively and one month postoperatively, symptoms were evaluated using the 5-item Dry Eye Questionnaire (DEQ-5) and the Ocular Surface Disease Index (OSDI), while noninvasive keratograph break-up time (NIKBUT), tear meniscus height (TMH), conjunctival hyperemia, and infrared meibography were measured by the Oculus Keratograph. Results: A total of 63 patients (mean age 75.1 ± 6.3 years) were analyzed. Patients receiving standard treatment showed no significant changes in OSDI (+2 ± 32.7; p = 0.859) or DEQ-5 scores (+1.7 ± 5.4; p = 0.204). Conversely, those receiving the adjunct of lid wipes and tear substitutes demonstrated significant improvement in OSDI scores (−19.4 ± 15.9; p < 0.0001), a trend toward improvement in DEQ-5 scores (−1.9 ± 5.5; p = 0.059), and a reduction in the meibography score of the inferior eyelid (−0.24 ± 0.60; p = 0.023). Intergroup comparisons showed significantly greater improvements in both OSDI and DEQ-5 scores in patients receiving treatment for the ocular surface. Multivariate regression analysis confirmed the association between the use of wipes and tear substitutes and improvements in OSDI (p = 0.010) and DEQ-5 scores (p = 0.015). No significant postoperative changes in objective OSD parameters were observed in either group. Conclusions: The addition of lid wipes and tear substitutes to the standard postoperative regimen significantly improved patient-reported symptoms of ocular discomfort after cataract surgery, while no significant changes were observed in objective signs of ocular surface disease. These findings support the routine use of lid wipes and tear substitutes as an effective strategy for managing postoperative ocular surface discomfort.

Background/Objectives: This study aims to explore the potential relationship between unilateral or asymmetric glaucoma and ipsilateral hearing impairment. Methods: In this retrospective study, visual and hearing functions were assessed in patients with unilateral or asymmetric glaucoma. Correlations between retinal nerve fiber layer (RNFL) thickness, visual field mean deviation (MD) values, and pure tone audiometry (PTA) measurements across various frequencies were analyzed to explore potential associations between visual and ipsilateral hearing functions. Differences in PTA values between ears ipsilateral to the more affected glaucomatous eyes and the contralateral ears were studied for statistical significance. Results: Twenty-six patients with unilateral or asymmetric glaucoma were included in the study. Significant differences in hearing thresholds between the ears corresponding to the more severely glaucomatous eyes and the contralateral ears were found at 0.7, 1, 1.5, and 3 kHz (p < 0.05). Additionally, a statistically significant difference was observed in the speech frequencies (0.5, 0.7, 1, 1.5, 2, 3, and 4 kHz) between ears corresponding to glaucomatous or more affected glaucomatous eyes and the contralateral ears (p = 0.016). Furthermore, a moderately positive correlation was found between differences in MD and PTA values at 0.125 kHz (r = 0.50; p = 0.01). Conclusions: This study highlights a potential association between unilateral or asymmetric glaucoma and ipsilateral hearing impairment, particularly at speech-relevant frequencies. These findings underscore the importance of integrated sensory assessment in the management of glaucoma patients, suggesting that early detection and intervention for concurrent hearing loss could enhance overall quality of life.