Glaucoma Treatments

Medications

These may be eye drops, eye ointments, or pills. Some drugs are designed to reduce pressure by slowing the production of fluid into the eye. Others help improve fluid drainage.

For most people with glaucoma, regular use of medications will control the progression of damage by lowering eye pressure, but these drugs may stop working over time, may cause side effects, or may not be effective enough to control the progression of damage. If a problem occurs, your eye care professional may select other drugs, change the dose, or suggest other ways to deal with the problem.

Common glaucoma medications include:

• Drugs that decrease the production of intraocular fluid:
  • Beta-blockers—Betimol, Betagan, Ocupress, Istalol, Timoptic
  • Carbonic anhydrase inhibitors (CAI)—Diamox, Neptazane, Azopt, Trusopt
  • Combination CAI/beta-blocker—Cosopt
• Drugs that increase the drainage of intraocular fluid:
  • Miotics—(rarely used) Isopto Carbachol, Ocusert Akarpine, E-Pilo
  • Prostaglandin—Lumigan, Xalatan, Travatan
• Drugs that may decrease production and increase drainage of intraocular fluid:
  • Sympathomimetic alpha-adrenergic agonist—Alphagan, Iopidine
  • Sympathomimetic nonselective—(rarely used) Epinal, Glaucon, Propine

Laser Surgery

During laser surgery, a strong beam of light is focused on the part of the anterior chamber where the fluid leaves the eye. This can help fluid exit the eye. Over time, the effect of laser surgery may wear off. Patients who have this form of surgery may need to keep taking glaucoma drugs.

Conventional Surgery

Surgery also can help fluid escape from the eye and thereby reduce pressure. However, surgery is usually reserved for patients who continue to progress despite maximum therapy with eye drops, pills, or laser surgery.

Observation

In some cases, if there is no decrease in the visual field, the patient and physician may decide not to treat glaucoma. Since glaucoma is a very variable disease, treatment decisions are made on an individual basis. In some instances, it may be difficult to diagnose glaucoma; many people have some signs of the disease, but do not necessarily have the disease. Therefore, some physicians decide to monitor patients as “glaucoma suspects” instead of committing them to treatment. Treatment is often initiated once changes consistent with glaucoma are detected.