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Glaucoma medications: A guide

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ProstaglandinsOther medicationsImportance of medicationsSummary
Untreated glaucoma can cause vision loss, but lowering the pressure in your eyes through glaucoma medications can help prevent further damage. Medications include prostaglandins and beta-blockers.
Medically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Written by Rashida Ruwa, RN
Updated on

Glaucoma is a chronic eye condition that worsens over time. It damages the optic nerve and can lead to vision loss if not treated. The main characteristic of glaucoma is increased eye pressure, known as intraocular pressure.

The main goal of glaucoma treatment is to lower intraocular pressure to prevent further damage to the optic nerve. To achieve this, healthcare professionals often prescribe glaucoma medications, available in the form of eye drops, oral tablets, or injections.

Glaucoma medications work by reducing fluid production in the eye or improving its drainage. Consider talking with a healthcare professional to create a treatment plan that suits your needs.

Prostaglandins 

A person reaching for some glaucoma medications while looking at their phone.
Photography by PT STOCK/Getty Images

Prostaglandin analog medications are considered the first line in the treatment of glaucoma and are the most effective at lowering intraocular pressure. 

Examples of prostaglandin medications include:

Prostaglandins improve the ability of the clear liquid inside your eyes to drain out through a specific pathway, reducing pressure in the eye. This helps lower the strain on the optic nerve and prevent further damage.

While prostaglandins are generally well-tolerated, like any medication, they can have side effects. These may include:

  • mild eye irritation
  • eye redness
  • darkening of the skin around the eye 
  • darkening of the iris (colored part of the eye)

Some people may also experience changes in eyelash appearance, such as increased length, thickness, or darkness. However, these side effects are usually temporary and reverse when you stop the medication.

If you have any concerns or experience any side effects, consider talking with a healthcare professional. They can provide guidance and support in managing these effects.

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Other medications

In addition to prostaglandins, several other glaucoma medications work in different ways to help lower intraocular pressure and manage the condition effectively.

Beta-blockers

Beta-blockers are considered effective in lowering intraocular pressure, and doctors often prescribe them when prostaglandins are not suitable or cause side effects. These medications work by reducing the production of aqueous humor, the fluid within the eye. If this liquid does not drain properly, it can increase intraocular pressure.

Examples of beta-blockers that treat glaucoma include:

Doctors typically give these medications as eye drops, and how often you use them depends on the specific medication and your treatment plan.

While beta-blockers can effectively lower intraocular pressure, they may also have some side effects. The most common side effects include:

  • eye irritation
  • stinging or burning sensation
  • temporary blurred vision immediately after eye drop administration

Beta-blockers may also cause systemic side effects, such as slowed heart rate, low blood pressure, and bronchospasm (tightening of your airways causing coughing) in people with asthma or chronic obstructive pulmonary disease (COPD)

If you have any pre-existing medical conditions, consider talking with a healthcare professional before starting beta-blocker treatment.

Carbonic anhydrase inhibitors

Carbonic anhydrase inhibitors (CAIs) are another class of medications doctors prescribe to treat glaucoma. They work by reducing the production of aqueous humor in the eye, which lowers intraocular pressure.

There are two types of CAIs: topical and systemic. Topical CAIs, such as dorzolamide (Trusopt) and brinzolamide (Azopt), are administered as eye drops, while systemic CAIs, such as methazolamide (Neptazane), are taken orally.

Like any medication, CAIs can have side effects. Common side effects of topical CAIs may include a burning or stinging sensation, discomfort, or blurred vision immediately after administration. 

Systemic CAIs can cause side effects such as:

CAIs are sometimes used as a secondary therapy when other medications alone are not enough to manage intraocular pressure. However, systemic CAIs may have more side effects and risks, so doctors typically only prescribe them for specific cases and will closely monitor your symptoms.

Alpha agonists

Doctors often prescribe alpha agonists as a secondary therapy to other glaucoma medications when they need to further reduce your intraocular pressure. Common examples include brimonidine (Alphagan P) and apraclonidine (Iopidine).

Alpha agonists work by reducing the production of aqueous humor and increasing fluid drainage from the eye, resulting in lower intraocular pressure. They can be used in combination with other glaucoma medications when further intraocular pressure reduction is needed.

Side effects of alpha agonists can include:

  • a temporary burning or stinging sensation upon administration
  • eye redness
  • dry mouth
  • drowsiness
  • dizziness
  • low blood pressure

The treatment of glaucoma and the specific treatment approach will depend on several factors, including the type and severity of glaucoma and your previous treatment history. Consider talking with a healthcare professional to determine the most suitable medication regimen for your condition.

Importance of taking the medications

Taking glaucoma medications as your doctor prescribes is important for several reasons, including:

  • Lowering intraocular pressure: Healthcare professionals prescribe glaucoma medications to help lower intraocular pressure, the primary risk factor for optic nerve damage and vision loss. This reduces the chance of disease progression.
  • Preserving vision: Glaucoma is a chronic and degenerative condition that can cause irreversible vision loss if not treated or poorly managed. By consistently taking prescribed medications, you are actively working to protect your vision and slow the progression of the disease.
  • Preventing further damage: Glaucoma medications help reduce the production of aqueous humor or improve its drainage, depending on the medication class. By effectively managing intraocular pressure, these medications help prevent further damage to the optic nerve and prevent complications such as vision loss.
  • Maintaining structural integrity: High intraocular pressure can damage the delicate structures of the eye, including the optic nerve and surrounding tissues. Taking your medications helps keep the structures healthy and function as they should.
  • Enhancing treatment outcomes: Combining glaucoma medications with regular eye exams and other recommended treatments, such as laser therapy or surgery if necessary, can maximize the effectiveness of your overall treatment plan. 

Summary

Glaucoma is a chronic eye condition that can lead to irreversible vision loss if not treated. The primary goal of glaucoma treatment is to lower intraocular pressure to prevent further damage to the optic nerve. 

Prostaglandin analogs like bimatoprost are commonly used as the first-line treatment due to their effectiveness in reducing intraocular pressure. While prostaglandins are generally well-tolerated, they can have side effects such as mild eye irritation, redness, and darkening of the iris. 

Other glaucoma medications, such as beta-blockers and carbonic anhydrase inhibitors, work through different mechanisms to lower intraocular pressure and manage the condition effectively. Be sure to talk with a healthcare professional before starting any medication.

Download the free Optum Perks Discount Card to save up to 80% on some prescription medications.

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