Medications for Glaucoma

Prescription medicines to lower the pressure inside the eye (intraocular pressure, or IOP) are used to treat all types of glaucoma. They work either by reducing the amount of fluid (aqueous humor) that is produced by the eye or by increasing the amount of fluid that drains out of the eye. These medicines may be given as eyedrops, as pills, in liquid form by mouth, or through a vein (in emergency situations). In most cases, eyedrops are used first. In congenital glaucoma, medicines may be used to decrease the pressure in the eyes and reduce the cloudiness of the clear front surface (cornea) of the child's eye. Medicines are usually only used until surgery can be done. When glaucoma has already caused vision loss, further vision loss may occur even after the pressure in the eye is lowered to the normal range with medicine. Talk to your doctor about the goals of treatment, how long the medicine will be tried, and the possible side effects. Eye medicines can cause symptoms throughout the body. Medicines that decrease the amount of fluid produced by the eye include.

Intraocular pressure can be lowered with medication, usually eye drops. Several classes of medications are used to treat glaucoma, with several medications in each class. Each of these medicines may have local and systemic side effects. Adherence to medication protocol can be confusing and expensive; if side effects occur, the patient must be willing either to tolerate them, or to communicate with the treating physician to improve the drug regimen. Initially, glaucoma drops may reasonably be started in either one or in both eyes. Poor compliance with medications and follow-up visits is a major reason for vision loss in glaucoma patients. A 2003 study of patients in an HMO found half failed to fill their prescriptions the first time, and one-fourth failed to refill their prescriptions a second time. Patient education and communication must be ongoing to sustain successful treatment plans for this lifelong disease with no early symptoms.

The possible neuroprotective effects of various topical and systemic medications are also being investigated.

  • Prostaglandin analogs
  • Beta blockers
  • Alpha agonists
  • Carbonic anhydrase inhibitors
  • Combined medications

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