Medications, including eye drops and pills, are often prescribed as part of a glaucoma treatment plan. For glaucoma medication to be completely effective it must be taken exactly as directed by your doctor.
Your doctor may prescribe eye drops as an initial treatment for glaucoma. Since small amounts of eye drops are absorbed into the bloodstream, your doctor will consider all your current medications before deciding what prescription is right for you.
There are many types of eye drops that help to lower intraocular pressure (IOP) and they work in a variety of ways:
- Prostaglandin analogs (such as Lumigan, Xalatan, Travatan and Travatan Z) are taken once per day and lower intraocular pressure (IOP) by opening up a new passage by which aqueous humor exits the eye.
- Beta blockers (such as Betopticm Ocupress, Betagan, Timoptic and Istalol) reduce the production of aqueous humor in the eye.
- Alpha-2 Adrenergic Agonists (such as Alphagan, AlphaganP and Iopidine) reduce aqueous humor production and increase drainage of intraocular fluid.
- Miotics (such as Iosptocarpine and Pilocar) open the eye’s drain and increase the rate of fluid flowing out of the eye.
- Topical Carbonic Anhydrase Inhibitors (such as Azopt and Trusopt) decrease the production of intraocular fluid.
- Cholinesterase Inhibitor (such as Phospholine Iodide) increases the amount of fluid that drains from the eye.
- Fixed combination Glaucoma Drugs (such as Cosopt and Combigan) decrease the production of aqueous humor. Many patients require more than one medication to control IOP so a few drug companies joined to create combination drops.
If eye drops do not sufficiently lower IOP, your doctor may prescribe pills to help decrease fluid flow in the eyes. Pills are usually taken 2 to 4 times each day. Oral medications can have more systemic side effects and may interact with other prescription drugs. It is important to write down all medications you are currently taking so your eye doctor can evaluate whether pills will be an effective part of your glaucoma treatment plan. Glaucoma pills are part of the carbonic anhydrase inhibitor family of drugs and should be taken with meals or with milk to reduce side effects. Eating bananas or drinking apple juice is helpful in minimizing potassium loss. Pills are often reserved for severe glaucoma or patients that are not good candidates for surgery as they often have severe side effects.
What to Expect
Often patients require more than one medication to control IOP. Your doctor may prescribe a combination drop (more than one type of eye drop mixed together), multiple eye drops, or a combination of eye drops and pills.