Goal of Glaucoma Treatment
The ultimate goal of treatment is to preserve the optic nerve tissue and avoiding loss of vision with the least amount of risk and side effects. This requires close monitoring with follow up visits with the appropriate testing. Although we don’t know all factors related to what causes glaucoma, the main stay is keeping the intraocular pressure (IOP) at a safe level. The more severe the glaucoma, the lower the IOP needs to be. Many doctors set a target pressure for their patients depending on their initial IOP and amount of glaucoma damage.
Eye drop medications are used to lower the eye pressure. There are several different classes of medications used to treat glaucoma. These eye medications can have local and systemic side effects. The systemic side effects are not as common as the local side effect in the eye. If you feel that you are having problems with the medicine immediately notify you doctor. Since open angle glaucoma doesn’t usually cause any symptoms, compliance with patients using their medications has been a major cause of vision loss with glaucoma. In most cases, the glaucoma can be controlled and people do not need to lose their vision from glaucoma as long as they follow the treatment plan and keep their follow up visits.
This is a miotic medication that works by contraction of the ciliary muscle putting traction on the trabecular meshwork allowing more flow through it. This drug is not used very much anymore as it has to be used 4 times a day and constricts the pupil causing problems with night vision.
Medicines such as Timoptic, Timolol, Betagan, Betimol, and Istalol decrease the production of the aqueous humor in the eye.
Medicines such as Xalatan (Latanoprost), Travatan and Travatan Z (Travoprost), and Lumigan (Bimatoprost) make the uveoscleral tissue more porous and increase the outflow of fluid.
Alpha 2-Adrennergic Agonists
Alphagan P (Brimonidine) work by decreasing aqueous humor production and increasing trabecular meshwork outflow.
Carbonic Anhydrase Inhibitors
Trusopt (Dorzolamide) and Azopt (Brinzolamide) work by decreased production of aqueous humor. Diamox (Acetazolamide) is an oral form of this type of medication.
Medicines such as Propine (Dipivefrin) work by increased outflow through the trabecular meshwork.