Medical Treatment for Glaucoma

The primary effect of most glaucoma medications is to lower IOP's. This has been proven over years to be an effective way to help prevent or slow the progression of the glaucoma disease. There are several different classes of prescription drops that Dr. Piemontesi uses to help control your IOP to a desirable range and control it over time.

What are the different classes of drops?

There are 5 different classes of medical drops:

Prostaglandin Analogues
This is the newest class of glaucoma drugs, which includes bimatoprost (Lumigan), travopost and latanoprost. Prostaglandin analogues were first introduced in 1996. They all work by increasing the flow of aqueous humor out of the eye, thus lowering IOP. Prostaglandin analogues are dosed once a day and effectively control IOP. One common side effect on the prostaglandin analogue is eye lash growth. Another, is redness of the eye. In patients new to this drug may appear more pronounced, but subsides to a mild level within a few weeks.

Beta Blockers
These drugs have been around to treat glaucoma for decades. The most commonly used beta blocker is timolol. The dosing of beta blockers ranges from once to twice daily. Beta blockers work by decreasing production of the aqueous humor, which lowers IOP. Some of the side effects include low blood pressure, slow hear rate, and general fatique.

Alpha Agonists
Brimonidine is the most common alpha agnoist. Alpha agonists cause an increase in outflow, as well as a decrease in production, of aqueous to lower IOP. Side effects may include ocular allergic reactions and drowsiness. Brimonidine has been shown in animal experiments to be "neuroprotective". This property may protect your optic nerve from glaucoma damage.

Carbon anhydrase inhibitors
Carbon anhydrase inhibitors are available in oral formulation or eye drops like brinzolamide or dorzolamide. Carbonic anhydrase inhibitors lower IOP by decreasing production of aqueous humor. The severe side effects, such as nausea and diarrhea, common with oral forms, are largely avoided with eye drops. The eye drops are fairly well tolerated, but may cause a minor ocular stinging or burning sensation.

Pilocarpine is the most common miotic. It has been around for decades. Miotics decrease IOP by increasing outflow of aqueous humor. Side effects may include blurred vision, brow ache, and small pupil size.

Sources: Alcon Canada