Saving Sight: A Guide to Glaucoma Eye Drops
Glaucoma is a group of eye diseases that can damage the nerve in the back of your eye called the optic nerve.
According to the National Glaucoma Research, Glaucoma is the leading cause of irreversible blindness in the United States and the world.
Its treatment aims at lowering intraocular pressure by increasing/decreasing the fluid produced by the eye.
Eye drops are usually the first line of treatment when treating Glaucoma.
These might be given standalone or in combination, depending on your condition.
Here, we are discussing some Glaucoma eye drops that doctors prescribe.
Prostaglandin analogues
Prostaglandins reduce eye pressure by increasing the outflow of fluid in the eyes. They also ease eye pressure.
Some of the salts belonging to this group are:
- Bimatoprost
- Latanoprost
- Travoprost
- Tafluprost
Presently, Latanoprost is the most well-documented medication among these.
It was also the first prostaglandin analogue approved by the FDA and is used off-label to treat various variants of Glaucoma.
The optimal dose is one drop once a day.
This lowers the pressure in the eye by about 30% in glaucoma patients.
Side effects of Prostaglandin analogue
The most common side effects seen due to these medications include:
- Changes in eyelid skin color
- Blurred vision
- Stinging
- Mild redness
- Itching
Beta-adrenergic blockers
Beta-blockers reduce the amount of fluid produced by the eyes.
This lowers eye pressure and helps in protecting the vision.
These beta blockers are of 2 types, nonselective and cardioselective beta-blockers.
Some commercially used beta-blockers include:
- Betaxolol
- Timolol
- Levobunolol
- Metipranolol
- Carteolol
The low risk of side effects with Betaxolol makes it the first choice of beta blocker for use.
Timolol and Levobunolol are used for patients for whom Betaxolol doesn’t respond well or those with no respiratory issues.
These three are FDA-approved medications for Glaucoma.
Side effects of Beta-adrenergic blockers
Possible side effects of these Glaucoma eye drops include:
- Trouble breathing
- Low blood pressure
- Impotence
- Fatigue
- Slower heart rate
Most of these side effects subside once you stop the medication.
If they cause discomfort, consult your doctor immediately.
Do not stop using the drops without your doctor’s permission.
Alpha-adrenergic agonists
Alpha-adrenergic agonists reduce the production of fluid that flows through the eyes.
They also increase the flow of fluid out of your eye, like prostaglandin analogue.
Apraclonidine and Brimonidine are majorly used Alpha-adrenergic agonists.
The FDA has approved both these Glaucoma eye drops.
Also read: To know what medications you must avoid to protect your vision, explore this informative article on Glaucoma Medications to Avoid: Protecting Your Vision to learn all about it.
Side effects of Alpha-adrenergic agonists
Possible side effects seen due to these medications include:
- Headache
- Itching in the eye
- Drowsiness
- High Blood Pressure
- Dry mouth
- Irregular heart rate
These side effects usually subside over time. But it is advisable to consult a doctor if you experience any discomfort.
Carbonic Anhydrase Inhibitors (CAI)
Like Beta blockers, Carbonic anhydrase inhibitors also reduce the amount of fluid produced by the eyes to lower eye pressure.
Dorzolamide and Brinzolamide are the two CAIs currently used to treat Glaucoma and are FDA-approved.
The medication is used as a 2% solution in monotherapy used three times daily.
However, you might be prescribed to use it twice a day combined with another Glaucoma eye drop to improve the condition.
Most people who use Dorzolamide for a long time do not face problems with their corneas or lenses.
Your doctor might prescribe it twice daily in monotherapy and thrice if combined with any other Glaucoma eye drops.
Side effects of CAI
The possible side effects include:
- Bitter taste
- Blurred vision
- frequent urination
- Stinging and burning eyes
Miotic or Cholinergic agents
Miotic agents work by increasing the amount of fluid produced by the eyes.
This helps to lower eye pressure.
They also constrict your pupil, which causes the eye to drain more fluid.
Pilocarpine is a miotic to treat Glaucoma.
Doctors usually prescribe to use of this class of medication up to four times daily.
But due to its potential side effects and the high frequency of usage, this medication is not prescribed very often.
Side effects of Miotic agents
The possible side effects observed in people using these Glaucoma eye drops include:
- Blurred vision
- Headache
- Nearsightedness
- Dim vision with difficulty seeing in the dark or at night
Rho kinase inhibitor
The rho kinase enzymes are responsible for the increase of fluid in the eye.
The medication belonging to this class lowers eye pressure by blocking the rho kinase enzymes.
Netarsudil is an example of a Rho kinase inhibitor used to treat Glaucoma.
These drops are FDA-approved, and doctors usually prescribe them to be used once every day.
Side effects of Rho kinase inhibitors
Possible side effects that could be observed if you are prescribed these Glaucoma medications include:
- Redness of the eye
- Eye discomfort
Combined medications
Sometimes, you might be prescribed two types of drops.
In such cases, you can use a combination of medications instead of two different ones.
Some existing combinations are:
- Brinzolamide + Brimonidine
- Timolol + Pilocarpine
- Timolol + Carbonic anhydrase inhibitor (dorzolamide or brinzolamide)
- Timolol + Brimonidine
- Timolol + Prostaglandin analogue (latanoprost, travoprost or bimatoprost)
| Medications for Glaucoma | Approx. cost |
| Careprost Plus Eye Drop | $25.38 |
| Dorzox T 5 ml | $12.05 |
| Xalatan Eye Drops of 0.005% (2.5 ml) | $27.20 |
| Bimat 3 ml | $12.24 |
| Dorzox Eye Drop 2% | $8.90 |
How to use Glaucoma eye drops
Knowing the correct way to use eye drops to avoid infections is essential.
- Shake the bottle if it says so on the label
- Gently pull your lower eyelid down with your finger to create a pocket
- Squeeze one drop of the medication into this pocket
- Close your eye and gently press on the corner of your eye
- Rewash your hands after completing the procedure in one or both eyes as prescribed by your doctor
You can do it standing up, in front of a mirror, or lying down. Try different ways to find out what is the easiest way for you.
If you are using multiple medications, it is suggested that you keep at least a 5-minute difference between the two.
Takeaway
Reversing the effects of Glaucoma is not possible since it damages the optic nerve.
Hence, treatments aim to lower the internal eye pressure that causes the condition.
The primary treatment for Glaucoma is eye drops which can be prescribed alone or in combination.
Frequently Asked Questions
Does Glaucoma always occur in both eyes?
Glaucoma usually affects both eyes, but one eye may be worse. In open-angle Glaucoma, one eye may be damaged moderately or severely, while the other eye may only be affected mildly.
Can you use a combination of Glaucoma drops to eliminate the need for two medications?
Yes, you can use combination medicines if prescribed by your doctor. Glaucoma eye drops which are usually prescribed together, come as a combination medication.
Can eye drop cure Glaucoma?
No, eye drops can not cure Glaucoma or reverse any vision loss. Glaucoma eye drops work to lower the intraocular pressure and prevent any further damage to the optic nerve.
