Glaucoma Treatments : Eye Drops and Other Medications

Glaucoma Treatment, Basics. Target Pressure. Drops. Laser Trabeculoplasty. Surgery Trabeculectomy

In this post we will deal with Glaucoma Drug Treatments.

Medication
Intraocular pressure can be lowered with medication, usually eye drops.
Each of these medicines may have local and systemic side effects.. Initially, glaucoma drops may reasonably be started in either one or in both eyes.
Poor compliance with medications and follow-up visits is a major reason for vision loss in glaucoma patients.

A 2003 study of patients in anHMO found half failed to fill their prescriptions the first time, and one-fourth failed to refill their prescriptions a second time. Patient education and communication must be ongoing to sustain successful treatment plans for this lifelong disease with no early symptoms.

The possible neuroprotective effects of various topical and systemic medications are also being investigated.
Prostaglandin analogs, such aslatanoprost (Xalatan),bimatoprost (Lumigan) andtravoprost (Travatan), increase uveoscleral outflow of aqueous humor. Bimatoprost also increases trabecular outflow.
Topicalbeta-adrenergic receptor antagonists, such astimolol,levobunolol (Betagan), andbetaxolol, decrease aqueous humor production by theciliary body.
Alpha2-adrenergic agonists, such asbrimonidine (Alphagan) andapraclonidine, work by a dual mechanism, decreasing aqueous humor production and increasing uveoscleral outflow.
Less-selectivealpha agonists, such asepinephrine, decrease aqueous humor production through vasoconstriction of ciliary body blood vessels, useful only in open-angle glaucoma. Epinephrine’s mydriatic effect, however, renders it unsuitable for closed-angle glaucoma due to further narrowing of the uveoscleral outflow (i.e. further closure of trabecular meshwork, which is responsible for absorption of aqueous humor).
Miotic agents (parasympathomimetics), such aspilocarpine, work by contraction of theciliary muscle, opening thetrabecular meshwork and allowing increased outflow of the aqueous humour.Echothiophate, an acetylcholinesterase inhibitor, is used in chronic glaucoma.
Carbonic anhydrase inhibitors, such asdorzolamide (Trusopt),brinzolamide (Azopt), andacetazolamide (Diamox), lower secretion of aqueous humor by inhibiting carbonic anhydrase in the ciliary body.
Physostigmine is also used to treat glaucoma.
Marijuana was found, in the early 1970s, to reduce pressure in the eyes, though how the cannabinoids in marijuana produce this effect remains unknown.

Surgery
Bothlaser and conventional surgeries are performed to treat glaucoma. Surgery is the primary therapy for those withcongenital glaucoma. Generally, these operations are a temporary solution, as there is not yet a cure for glaucoma.

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