Eye Drops & Medication for Glaucoma

What are the medications to treat glaucoma?

Initially, eye drops are the treatment for glaucoma. These medications can reduce elevated intraocular pressure either by improving the outflow of the fluid in the eye (aqueous humor) or by reducing the production of this fluid.

The conventional treatment for mild to moderate glaucoma are eye drops and laser surgery. Eye drops are a common and effective treatment for managing glaucoma, the aim is to lower eye pressure to prevent further damage to the optic nerve, thereby slowing the progression of the disease.

What are the types of eye drops?

There are several types of eye drops used for glaucoma, each working in a different way to achieve this goal:

1. Prostaglandin Analogs: These increase the outflow of the aqueous humor, the fluid in the eye, thereby reducing the intraocular pressure (IOP). Examples include latanoprost (Xalatan), bimatoprost (Lumigan), and travoprost (Travatan Z).
2. Beta Blockers: These reduce the production of fluid in the eye, lowering the eye pressure. Examples include timolol (Timoptic) and betaxolol (Betoptic).
3. Alpha Agonists: These both decrease the production of aqueous humor and increase the outflow, reducing eye pressure. Examples include brimonidine (Alphagan P) and apraclonidine (Iopindine).
4. Carbonic Anhydrase Inhibitors (CAIs): These reduce eye pressure by decreasing the production of intraocular fluid. They are available in eye drop form, such as dorzolamide (Trusopt) and brinzolamide (Azopt), and also in pill form.
5. Rho Kinase Inhibitors: A newer class of eye drops that reduce eye pressure by increasing the outflow of aqueous humor through a different mechanism. An example is netarsudil (Rhopressa).
6. Miotic or Cholinergic Agents: These increase the outflow of aqueous humor by contracting the pupil and pulling the iris away from the drainage angle. An example is pilocarpine.
7. Combined Medications: Combined medications can offer an alternative for patients who need more than one type of eye drop. Rocklatan is a combination of a rho kinase inhibitor and a prostaglandin analog. Combigan is a combination of beta blocker and alpha agonist. Cosopt is a combination of beta blocker and carbonic anhydrase inhibitor. Cosopt is available in generic form, and also as a preservative-free formulation (Cosopt PF). Simbrinza is a combination of Brinzolamide (a carbonic anhydrase inhibitor) and Brimonidine (an alpha agonist).

Using your glaucoma eye drops

• It’s important to use these medications exactly as prescribed by an eye care professional, usually every day. Drops may need to be used once a day, twice a day or three times a day.
• Your vision will not improve from the use of eye drops. The goal is to prevent vision loss from becoming worse.
• Glaucoma often has no symptoms in its early stages, and consistent use of prescribed eye drops is crucial for preventing vision loss.
• Glaucoma is a lifelong conditions so you will need to use eye drops for the rest of your life.
• Side effects can vary depending on the type of medication and the individual, ranging from mild eye irritation or redness to more systemic effects such as low blood pressure, changes in heart rate or breathing difficulties, particularly with beta blockers. Always discuss potential side effects and your medical history with your Union Square Eye Care doctor to ensure the best treatment plan for you.

What are oral medications for glaucoma?

Oral medications for glaucoma are typically used when eye drops are not sufficient to lower the eye pressure and a rapid reduction of intraocular pressure is necessary. Oral medications for glaucoma are generally considered adjunctive therapy, used in conjunction with other treatments like eye drops or surgery when those alone are insufficient to control eye pressure.

Due to their potential for systemic side effects, they are prescribed under careful consideration by your eye doctor who will weigh the benefits against the risks for each individual patient. Regular monitoring and follow-up appointments are crucial to managing glaucoma effectively while minimizing the risk of side effects.

Contact Union Square Eye Care to schedule an appointment to schedule a consultation with one of our board – certified eye doctors to discuss the best eye drops and medications to help you control your glaucoma. We have offices in Union Square and Harlem for your convenience. You will always be treated with respect and dignity.

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References

• https://www.aao.org/eye-health/diseases/glaucoma-eyedrop-medicine
• https://www.americanglaucomasociety.net/patients/patient-education
• Gurnani B, Tripathy K. Minimally Invasive Glaucoma Surgery. [Updated 2023 Aug 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK582156/