“…Multiple studies have documented the deleterious effects of BAK on the ocular surface, ranging from corneal epithelial damage to chronic lymphocytic infiltration and fibroblast proliferation. [1][2][3][4][5][6][7][8]11,12 A recent study by Malvitte et al 3 examined the inflammatory response to chronic topical glaucoma therapy in humans through tear cytokine levels by using multiplex bead analysis. Cytokines studied included interleukin (IL) 1b, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, granulocyte-colony stimulating factor, granulocyte-macrophage stimulating factor, interferon g, monocyte chemotactic Blunting of tips with #50% loss of surface microvilli 4…”