The Role of Medications in the Treatment of Glaucoma
Once the diagnosis has been made that someone has glaucoma or is at high risk of developing glaucoma a decision will be made regarding treatment options. At the present time, all treatments have the goal of lowering eye pressure. Options for treatment include medications, laser procedures, and surgical interventions. Laser and surgical interventions are discussed elsewhere on this site.
There are many medications available for the treatment of glaucoma grouped into categories and by mechanism of action. With rare exception, medications will be in the form of eye drops but oral medications are also available. We like eye drops because they target the eye better.
Some medications lower eye pressure by facilitating the outflow of a clear fluid in the eye called aqueous. Other medications work by slowing aqueous production within the eye. And some medications have dual actions.
Unfortunately, not every drop will work on everyone. The decision as to which medication to select can be complex. Under certain circumstances some medications are more likely to be effective than others. We would also like to offer as simple a medication regimen as possible with some medications being effective when taken only one time per day. However, some patients will require more than one medication dosed multiple times per day to adequately control their glaucoma.
Long term treatment with eye drops can have consequences. Some patients will eventually experience increased redness, dryness, itchiness, or irritation. This can be quite uncomfortable. These side effects are caused by repeated exposure to the medication itself or caused by repeated exposure to preservatives that are present in eye drop preparations. Preservatives prevent microorganism growth from occurring in the bottles of drops but they can be harsh on the eye in the long run. More recently, drug manufacturers have addressed this concern by introducing preservative-free versions of some of the currently available eye drop preparations.