Glaucoma Treatment With Eye Drops

Glaucoma occurs when the optic nerve of the eye is damaged by high pressure inside the eye. Often, the first treatment for glaucoma is eye drops; these drops either decrease the amount of fluid formed in the eye or increase the outflow of the fluid inside the eye.

Beta Blockers

• At one time, beta blocker eye drops such as Timoptic (timolol) or Betoptic (betaxolol) were the first line of treatment in patients with glaucoma; beta blockers decrease the creation of fluid inside the eye and are often prescribed now in combination with other medications.

Alpha-Adrenergic Agonists

• This type of eye drop also decreases the production of the fluid in the eye, but it also increases outflow of fluid from the eye. Examples of this type of eye drop include Alphagan (brimonidine) and Iopidine (apraclonidine).

Carbonic Anhydrase Inhibitors

• Carbonic anhydrase inhibitors (CAI) decrease the amount of fluid production; when these medications (Trusopt (dorzolamide) and Azopt (brinzolamide)) were first introduced, they were used alone but now are used in combination with other eye drops.

Prostaglandins

• Prostaglandins like Xalatan (latanoprost), Lumigan (bimatoprost) or Travatan Z (travoprost) have become popular because they are effective and have to be only taken once a day; these agents increase the outflow of fluid as well.

Combination Eye Drops

• In combination eye drops, different drops are combined in one eye drop and the pressure reduction from each drop is added together for a greater pressure reduction. Examples are Cosopt (a CAI with a beta blocker), Combigan (CAI and a beta blocker) and, outside of the United States--DuoTrav (prostaglandin and beta blocker).

Eye Drop Use

• These medications must be used as prescribed by the eye doctor to be effective; care must also be taken when placing the eye drops in the eye as this can be difficult for patients to do correctly.