Glaucoma treatments

Glaucoma Treatments

Glaucoma is commonly treated with eye drops, and surgery for some forms or when drug therapy is not effective.

There are a number of different categories of eye drops, but all are used to either decrease the amount of fluid (aqueous humor) in the eye or improve its outward flow. Sometimes doctors will prescribe a combination of eye drops.

People using these medications should be aware of their purpose and potential side effects, which should be explained by a medical professional.

Types of Medications

1. Alpha adrenergic agonists

Action  reduce aqueous humor production and increase its outflow.

Side effects Allergic reactions frequently occur with this class of medication, increased heart rate, elevated blood pressure, headaches, blurry vision, fatigue, dry mouth, and redness in or around the eye.

Examples

• apraclonidine (Iopidine)
• brimonidine (Alphagan)
• epinepherine (Gluacon and Epifrin)
• dipivefrin (Propine)

2. Beta blockers

Action work to lower eye (intraocular) pressure by decreasing the rate at which fluid flows into the eye.

Side effects may include a slow or irregular heartbeat, depression, impotence, drowsiness, double vision, and breathing problems for patients with asthma or emphysema.

Examples

• timolol (Timoptic XE Ocumeter and Timoptic)
• levobunolol (Betagan)
• carteolol (Ocupress)
• metipranolol (OptiPranolol)
• betatoxol (Betoptic)

3. Carbonic anhydrase inhibitors       (eye drops or pills )

Action  used to reduce fluid production in the eye.

Side effects may include skin rash, eye redness or irritation, headache, nausea or upset stomach, altered taste (especially with carbonated beverages), weight loss, fatigue and decreased energy.

Examples

• dorzolamide (Trusopt)
• brinzolamide (Azopt)
• acetazolamide (Diamox) – oral medication
• methazolamide (Neptazane) – oral medication

4. Miotics (cholinergic agents)

Action help increase the rate of fluid drainage from the eye.

Side effects may include red eyes, headache, and blurry or cloudy vision.

Examples

• pilocarpine (Isopto Carpine, Travatan ,Pilocar and Pilopine HS ointment)
• echothiophate (Phospholine Iodide)

5. Prostaglandin analogs

Action reduce pressure in the eye by increasing the outward flow of fluid from the eye.

Side effects may include eye redness or irritation, a change in eye color (mostly in hazel or green eyes), increase in thickness and number of eyelashes, and joint aches or flu-like symptoms.

Examples

• latanoprost (Xalatan)
• bimatoprost (Lumigan)
• travoprost (Travatan)

 6. Combinations of eye drops

 Also used to achieve better results.

 Side effects for these medications are mentioned above.

Examples

• dorzolamide and timolol (Cosopt)
• latanoprost and timolol (Xalacom)
• brimonidine and timolol (Combigen™)

                         


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Conventional Filtration Surgery

Normally, conventional filtration surgery is used as a therapy for glaucoma after other treatment strategies, such as medications and laser surgery, have failed. It is most often performed with the open-angle form of the disease. Two procedures are used almost exclusively or only for infants with congenital glaucoma. When deciding on a treatment option, an ophthalmologist will take into account the unique aspects of each person’s case, including severity of the disease, response to medication and other health issues.

                                          

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Laser Surgery

Depending in the type of procedure, laser surgery may be used for open-angle, closed-angle or neovascular glaucoma. A laser is directed toward the trabecular meshwork, the iris, ciliary body or the retina and is used in various ways to reduce eye pressure. Laser surgery is performed on an outpatient basis in an eye doctor’s office or clinic after the eye has been numbed.