What does the first line of glaucoma treatment look like?

Glaucoma is often initially treated with either oral or topical medication such as eye drops. These work to reduce intraocular pressure by increasing the amount of fluid drainage from the eye or by reducing the amount of fluid produced within the eye. Oral glaucoma medications may also be prescribed. Oral medications may be used in conjunction with topical medications to reduce intraocular pressure. Typically, medications are intended to reduce elevated intraocular pressure and prevent damage to the optic nerve. Our glaucoma eye doctors may prescribe a combination of medications or change your prescription over time to reduce side effects or provide a more effective treatment.
Eye drops are sometimes hard to put in the eye. It is okay to have a friend or family member help you administer an eye drop. It does not matter which part of the eye that the eye drop touches, as long as it gets onto the eye (hitting the eye lid is NOT enough)! Sometimes people find eye drops so comfortable that they don’t actually know if the eye drop has touched their eye or not. If you are having trouble with this, you may decide to put the drop in your refrigerator. Drops do not require refrigeration, but it may be easier to determine whether a cold eye drop has actually touched your eye or not compared to an eye drop which is at room temperature.

Most eye drops may sting or burn when placed in the eye. This does not mean that they are not working or that they are bad for you. It just means that some people may find a specific eye drop more comfortable than others.

Prescription eye drop medications include:

• Prostaglandins Analogs. These increase the outflow of the fluid in your eye (aqueous humor) and reduce pressure in your eye. Examples include latanoprost (Xalatan) and bimatoprost (Lumigan). 

• Beta blockers. These reduce the production of fluid in your eye, thereby lowering the pressure in your eye (intraocular pressure). Examples include timolol (Betimol, Timoptic) and betaxolol (Betoptic). 

• Alpha-adrenergic agonists. These reduce the production of aqueous humor and increase outflow of the fluid in your eye. Examples include apraclonidine (Iopidine) and brimonidine (Alphagan).

• Carbonic anhydrase inhibitors. Rarely used for glaucoma, these drugs may reduce the production of fluid in your eye. Examples include dorzolamide (Trusopt) and brinzolamide (Azopt).

• Miotic or cholinergic agents. These increase the outflow of fluid from your eye. An example is pilocarpine (Isopto Carpine).