At NYU Langone, the goal of glaucoma treatment is to prevent a loss of vision. Because glaucoma is a pressure-sensitive disease, treatment focuses on reducing pressure on the optic nerve, regardless of the severity.
For most people, medications delivered as eye drops are the first course of action. If these medications aren’t enough, doctors may introduce additional therapies.
Ophthalmologists choose these medications based on your health and what they think might work best for you. Sometimes your doctor may prescribe a combination of medications.
Prostaglandin analogs are powerful medications derived from the body’s own prostaglandins, which are hormones that act as chemical messengers to help heal tissue damage or infection. Prostaglandin analogs promote the drainage of fluid from the eye back into the bloodstream.
Prostaglandin analogs have replaced beta blockers as the most commonly prescribed drops for glaucoma because they are taken just once daily, are highly effective, and cause almost no systemic, or whole body, side effects.
Prostaglandin analogs can cause reddening or stinging of the eye, lengthening of the eyelashes, and rarely may darken the color of the iris for people with hazel eyes.
Beta blockers reduce the production of fluid and the amount of pressure in your eye. The drops are used once or twice a day.
While effective and well tolerated, these drops may cause side effects, such as a slowed heart rate, and can worsen any breathing problems. If you have a heart or lung condition, your ophthalmologist may recommend another medication or treatment.
Alpha-adrenergic agonists are drops that reduce the production of fluid in your eye and increase its drainage. Used two or three times a day, they can trigger side effects, including allergy to the medication, dry mouth, fatigue, and drowsiness.
Carbonic anhydrase inhibitors work by decreasing the rate of fluid production. They are available as eye drops or pills taken by mouth. Your doctor can recommend the form of medication that’s best for you. The drops are usually used two or three times daily.
Miotics are eye drops that cause the pupil to constrict, allowing the blocked drainage angle to open. They may be used two, three, or four times daily.
These medications are now reserved for use in people whose glaucoma does not improve with other medications. Miotics may cause some eye discomfort and redness.