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. For example,

• Prostaglandin analogs open a new passage to allow the aqueous humor (fluid) to exit the eye.
• Beta blockers lower IOP by decreasing the overall production of aqueous humor.

Other eye drops decrease the production of intraocular fluid or increase drainage. Many patients require more than one medication to control their IOP, and their doctor may prescribe a combination drop (more than one type of eye drop mixed together).

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 two to four 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.

Often patients require more than one medication to control IOP. Your doctor may prescribe a combination drop, multiple eye drops, or a combination of eye drops and pills.