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Eye Drops for Glaucoma: What Works Best?

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The main goal of eye drops for glaucoma is to lower the pressure in your eyes to protect your optic nerve. These eye drops are available by prescription.

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There are several different types of eye drops for glaucoma, which are classified by their active ingredient. These eye drops either reduce the amount of fluid your eyes produce or help to drain the fluid. Both help to lower the pressure in your eyes.

Using eye drops for glaucoma daily, or several times per day, can help to preserve your vision and keep your glaucoma from progressing. As with any medication, there are some potential side effects.

Talk to your eye doctor about the best eye drops or other treatment method for your glaucoma.

Types of Glaucoma Eye Drops

man using eyedropper on left eye

Glaucoma medications are separated based on their main active ingredient. There are several different classes of prescription eye drops.

Your eye doctor can determine the best eye drops for you specifically, based on your health history, other conditions, or medications you are taking.

You may have to try a few different types of eye drops before settling on the one that is ideal for you. Combination medications can also be beneficial. The best eye drops will successfully keep the pressure in your eyes low enough to prevent damage to your optic nerve.

These are types of eye drops for glaucoma:

Prostaglandin analogs

Lumigan (bimatoprost), Xalatan (latanoprost), Zioptan (tafluprost), Travatan Z (travoprost)

Beta blockers

Betimol, Timoptic, Istalol (timolol), Betoptic (betaxolol)

Carbonic anhydrase inhibitors

Azopt (brinzolamide), Trusopt (dorzolamide)

Alpha-adrenergic agonists

Lopidine (apraclonidine), Alphagan P, Qoliana (brimonidine)

Rho-kinase inhibitors

Rhopressa (netarsudil)

Miotic or cholinergic agents

Isopto Carpine (pilocarpine)

Nitric oxides

Vyzulta (latanoprostene bunod)

Combined medications

Cosopt and Cosopt PF (timolol and dorzolamide), Simbrinza (brimonidine and brinzolamide), Combigan (timolol and brimonidine)

How Eye Drops for Glaucoma Work

Glaucoma eye drops are effective at controlling your IOP if you take them exactly as directed. You need to put them directly into your eyes up to four times every day.

These medications work in one of two ways to control the pressure in your eyes. They either help the fluid in your eyes drain more effectively, or they keep your eyes from producing as much fluid. Both of these methods help to lower IOP.

Prostaglandin analogs, nitric oxides, Rho kinase inhibitors, and miotic or cholinergic agents increase fluid drainage. Beta blockers, alpha-adrenergic agonists, and carbonic anhydrase inhibitors lower fluid production.

Pros & Cons of These Eye Drops

Many forms of eye drops for glaucoma can have systemic side effects, meaning they can impact your entire bodily system. Eye drops are placed topically into the eye, but they still enter your bloodstream this way.

These are potential side effects of glaucoma eye drops:

  • Blurry vision
  • Dry mouth
  • Headache
  • Changes in eye color
  • Eye irritation, including stinging, burning, itching, and/or redness
  • Fatigue
  • Drowsiness
  • Lower blood pressure and heart rate
  • Shortness of breath
  • Decreased night vision
  • Allergic reaction

Eye drops that contain preservatives can have toxic effects on your eyes. As a result, preservative-free eye drops are often a better option.

Glaucoma eye drops have to be used every day to keep the eye pressure down. Often, they must be used several times per day. When used correctly, they can be very effective at regulating eye pressure and therefore preserving your vision.

There are a lot of options for eye drops that control IOP. For glaucoma treatment, eye drops are considered the front-line treatment option. Occasionally, you may need to also take oral medications in conjunction with eye drops.

Talk to your eye doctor to find your ideal course of action for managing glaucoma.

References

  1. What Is Glaucoma? (October 2020). American Academy of Ophthalmology (AAO).
  2. Glaucoma Medications. (June 2019). National Eye Institute (NEI).
  3. Glaucoma Medications and Their Side Effects. (July 2018). Glaucoma Research Foundation.
  4. An Eye on Glaucoma Drugs. (August 2018). Harvard University.
  5. Glaucoma Therapy: Preservative-Free for All? (April 2018). Clinical Ophthalmology.
  6. A Guide to Applying IOP-Lowering Drugs. (July 2018). Review of Optometry.

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