Glaucoma medication is divided into groups based on chemical structure and pharmacologic action. The goal of currently available glaucoma therapy is to preserve visual function by lowering intraocular pressure (IOP) in patients that have an increased intraocular pressure.
Medical uses Agents in common clinical use include:
Prostaglandin analogs Parasympathomimetic (miotic) agents, including cholinergic and anticholinesterase agents Carbonic anhydrase inhibitors (oral and topical) Adrenergic antagonists (nonselective and selective Beta1-antagonists) Alpha 2 agonists Hyperosmotic agents Nitric oxide donators Rho kinase inhibitors
When comparing people with primary open-angle glaucoma and ocular hypertension, medical intraocular pressure lowering treatment slowed down the progression of visual field loss.
Comparison table Name Other names Mechanism of action Dosage IOP decrease Side effects Prostaglandin analogs Latanoprost Xalatan Increased USO (uveoscleral outflow ) Once daily 25-32% pigmentation of eyelashes, eyelid skin pigmentation, hyperemia (red eye), flu-like symptoms (joint/muscle pain and headache) Bimatoprost Lumigan Increased USO (uveoscleral outflow ) Once daily blurred vision, eyelid redness, eye discomfort, permanently darken iris, darken/thicken eyelashes Travoprost Travatan Increased USO (uveoscleral outflow ) Once daily blurred vision, eyelid redness, eye discomfort, permanently darken iris, darken/thicken eyelashes Beta blockers Timolol Timoptic Decrease aqueous production Every 12 hours 20-30% bronchospasm, bradycardia, depression, impotenceBetaxolol Betoptic Decrease aqueous production Every 12 hours 15-20% Fewer pulmonary complications due to selective Beta blockage Adrenergic agentsBrimonidine Alphagan Decrease aqueous production, increase USOevery 8–12 hours20-30%blurring, foreign body sensation, eyelid edema, dryness, headache, fatigue, hypotension, depression, insomnia MioticsPilocarpineIsoptocarpine, PilocarIncrease trabecular outflowEvery 6–12 hours15-25%posterior synechia, keratitis, miosis, brow ache, cataract, myopia, retinal tear, dermatitis, increased salivation Carbonic anhydrase inhibitorsDorzolamideTrusoptDecrease aqueous productionEvery 8–12 hours15-20%eye irritation, bitter tasteBrinzolamide AzoptDecrease aqueous productionEvery 8–12 hours15-20%eye irritation, bitter tasteAcetazolamideDiamoxDecrease aqueous productionEvery 6–12 hours15-20%malaise, depression, weight loss, kidney stones
Combinations Fotil is a combination drug consisting of:FASS (drug formulary): Fotil. Retrieved 2015-02-17 Pilocarpine, a parasympathomimetic Timolol, a beta-adrenergic receptor antagonist
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