Introduction

Eye doctors use many medicines to treat glaucoma. These drugs lower pressure inside the eye. Often, people with glaucoma must take these medicines for life to control the pressure and limit vision loss.

Glaucoma medicines are usually in the form of drops, but also come in pills or ointment. They work to lower the amount of aqueous fluid produced and/or improve fluid drainage in the eye.

Doctors are researching new drugs that can protect or strengthen the optic nerve. Some medicines already available may help stabilize the optic nerve as well as lower pressure inside the eye.

All glaucoma medicines may cause side effects, some of which can be uncomfortable. A few side effects can be quite serious, but those side effects are not common.

The glaucoma medicines listed below are grouped by the way they work. Some of the possible side effects are also listed. Not every drug in a category will have all the possible side effects listed. Your doctor can tell you which side effects are possible with the medicines you use.

Remember, you and your doctor must work together to determine the best medicines for you.

Types of Medicines

Prostaglandin Analogues are drugs that lower pressure in the eye by improving fluid drainage. They have the advantage of requiring use only once per day.

Possible side effects. A rare side effect may be a darkening of eye color. Often, there is an increased growth of eyelashes. Side effects can also include redness, itching, burning and blurred vision.

Prostaglandin Analogues

Beta-blockers decrease pressure inside the eye by reducing the amount of aqueous fluid your eye makes. These medicines are available as eye drops.

Possible side effects include possible respiratory problems, lowered heart rate and blood pressure, blurred vision, tiredness, forgetfulness, and changes in blood cholesterol levels. People with asthma, some kinds of heart disease or low blood pressure should be very careful about using beta-blockers to treat their glaucoma. Also, if a patient is on other "blocker" medicines for other health problems, the combined effect of the drugs could cause problems.

This is why it's important to tell all of your doctors about all the medicines you are taking.

Beta Blockers

This is why it's important to tell all of your doctors about all the medicines you are taking.

Alpha-adrenergic agonists are eye drops that lessen the amount of aqueous fluid the eye makes and may also increase flow of fluid out of the eye. These drops are sometimes used after laser surgery (see page 18) to prevent sudden rises in pressure.

Possible side effects include allergic reactions, dry mouth, burning of the eyes, dilated pupils, nasal decongestion,
and drowsiness.

Alpha-Adrenergic Agonists

Carbonic anhydrase inhibitors come in pills or drops. They reduce the amount of aqueous fluid the eye makes. Often, they are used when other drugs have not worked fully.

Possible side effects. The more common eye drop form of this drug may cause stinging, burning, a feeling of something in the eye, and an odd taste in the mouth. Taken as pills (only rarely nowadays), these drugs can have side effects throughout the body, including fatigue, tingling in the hands and feet, depression, frequent urination, anemia, kidney stones, loss of appetite, weight loss, diarrhea, and stomach cramps. Monitoring the dose of the oral pill and taking the medicine with food may help. Pregnant women and people sensitive to sulfa-related drugs should not take these medicines. A toxic reaction may occur if taken with large doses of aspirin. Very rarely, these drugs can lead to serious conditions known as Stevens-Johnson syndrome and aplastic anemia.

Carbonic Anhydrase Inhibitors

Miotics lower pressure by tightening tiny muscles inside the eye. This helps to open up the eye's drainage system, making it easier for aqueous fluid to flow out of the eye. Miotics come in eye drops or gels. When used as drops, these drugs usually need to be used several times a day, increasing the chance of forgetting a dose. Miotics are not commonly used any more except in certain cases.

Possible side effects include decreased pupil size, blurred vision, poor night vision, nearsightedness, watering eyes, brow and eye aches, and allergic reactions.

Miotics

Other Medicines

Anticholinesterase Iodide

Combinations containing two medicines in the same bottle

Cosopt® = Timoptic® and Trusopt®

Xalacom® = Xalatan® and timolol

E-pilo® = Epinephrine® and pilocarpine

Follow your treatment plan!

It's up to you to follow your treatment plan and have regular follow-up visits. At follow-up visits, your doctor will check to see if your glaucoma is getting worse. Remember to report anything you believe may be a side effect of the medicine you are taking.

Don't Skip Doses!

Take your medicine as scheduled. Skipping doses of your medicine may put your vision in danger and mislead your doctor. Be sure to tell your doctor if you've missed any doses.

With a chronic disease like glaucoma, it can be hard to remember to use medicines as directed. It may help to link taking medicine to the things you do every day like eating meals or brushing your teeth.

After evaluating your progress, your doctor may try changing your doses, switching medicines or changing other parts of your treatment to find the best results for you. Sometimes simple changes like adjusting your schedule to take your medicines at mealtimes or before bed can make your drug routine more comfortable.

More Topics:

Tips for Taking Your Glaucoma Medicine

How to Take Eye Drops

Treating Glaucoma with Laser Surgery

Treating Glaucoma with Glaucoma Surgery

This web resource is made possible through an unrestricted educational grant from Alcon.

Copyright © 2005 Prevent Blindness America ®

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