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Eye Drops for Glaucoma Treatment

Although there is no cure for glaucoma, there are many glaucoma treatments that can reduce the degree of damage to your optic nerve.  Eye drops are the first line of treatment in most cases of primary open angle glaucoma, the most common form.  Most people with angle closure glaucoma are treated with surgery due to the potential for immediate damage to the optic nerve.

Types of Eye Drops for Primary Open Angle Glaucoma

Since open angle glaucoma is often slow to develop and may take a long time to cause significant damage to the optic nerve, eye drops are the first-line treatment of choice for this condition.  There are currently five types of eye drops prescribed for open angle glaucoma treatment.

Prostaglandin analogs have become the eye drop of choice for many ophthalmologists.  They are often good at reducing intraocular pressure and have a very low incidence of side effects.  Side effects do include the darkening of the eye and thickening of eye lashes, temporary blurring of the vision, and slight discomfort.  The three types of prostaglandin analogs Lumigan (bimatoprost), latanoprost (Xalatan), and Travatan (travoprost) work by increasing the outflow of aqueous humor through different mechanisms.

Beta blockers (Beta-adrenergic antagonists) were the first type of eye drop popularly used to help control intraocular pressure. They work by decreasing the rate of production of aqueous humor. However, these drugs have been found to have significant side effects, especially for people with heart and respiratory conditions.  This makes them a second-line treatment for many patients.  They are often used in combination with prostaglandin analogs.

Adrenergic drops work by simultaneously reducing the production of aqueous humor and increasing its outflow from the eye. Common side effects include discoloration of the white of the eye, blocked tear ducts, and, less commonly, heart palpitations and an accelerated heart rate.

Alpha-adrenergic antagonists work by decreasing the rate of aqueous humor production.  They should not be used in patients taking monaamine oxidase inhibitors (MAO inhibitors).  A person taking tricyclic antidepressants may see little to no reduction in intraocular pressure.  They should also not be used in patients using beta blockers either for glaucoma or cardiovascular treatments.  Common side effects include red eyes and dilated pupils.

Carbonic anhydrase inhibitors work by inhibiting the production of aqueous humor.  These are offered both as eye drops and as pills, but the pill form has a high level of serious side effects, including tingling or loss of strength in the extremities, depression, memory loss, kidney stones, and frequent urination.  Red eye, blurred vision, and punctate keratopathy--the presence of small growths in the cornea--are side effects of the eye drops.

Eye Drops and Other Medications for Angle Closure Glaucoma

Angle closure glaucoma and any other glaucoma in which intraocular pressure is very elevated and must be reduced quickly may be treated with hyperosmotic agents, which are hydrophilic, and extract fluid from the eye through osmotic processes.  Commonly used medications include oral glycerin, mannitol, urea, and isosorbide.

Parasympathomimetic (Miotic) agents work to increase drainage from the eye by reducing pupil size.  This keeps the iris from bunching up over the narrow angle and blocking the exit of aqueous humor.  Minor side effects include dim vision.  More serious side effects may include induced myopia and retinal detachment.

If Eye Drops Don't Control Your Glaucoma

Not all eye drops work for every person.  It may take several tries to find the right medication for you.  For more than half of glaucoma patients, multiple medications are necessary, so some companies offer combination forms of eye drops.

If no combination of eye drops works to control your intraocular pressure, laser glaucoma surgery or canaloplasty may be indicated.

To learn more about the danger of glaucoma and how vision loss can be prevented, find a local ophthalmologist and schedule a consultation today.

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