Glaucoma medication is divided into groups based on chemical structure and pharmacologic action. The goal of currently available
glaucoma
Glaucoma is a group of eye diseases that result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...
therapy is to preserve visual function by lowering
intraocular pressure
Intraocular pressure (IOP) is the fluid pressure inside the eye. Tonometry is the method eye care professionals use to determine this. IOP is an important aspect in the evaluation of patients at risk of glaucoma. Most tonometers are calibrated to ...
(IOP), below a level that is likely to produce further damage to the nerve.
The more advanced the glaucomatous process on initial presentation, the lower the target range generally needs to be to prevent further progression. This more aggressive target is meant to minimize the risk of progressive glaucoma damage and vision loss. Once the optic nerve is damaged, it is more likely to incur more damage, and if severe visual loss is present, there is greater impact on the patient from any additional damage that may occur.
An initial reduction in the intraocular pressure of 20% from baseline is suggested. However, reduction of IOP to the target pressure range does not guarantee that progression will not occur. Therefore, the target pressure range needs to be constantly reassessed and changed as dictated by IOP fluctuations, optic nerve changes, and/or visual field progression.
Medical uses
Agents in common clinical use include:
* Prostaglandin analogs
*
Parasympathomimetic (miotic) agents, including cholinergic and anticholinesterase agents
*
Carbonic anhydrase inhibitor
Carbonic anhydrase inhibitors are a class of pharmaceuticals that suppress the activity of carbonic anhydrase. Their clinical use has been established as anti-glaucoma agents, diuretics, antiepileptics, in the management of mountain sickness, ...
s (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
Combinations
Fotil is a
combination drug
A combination drug or a fixed-dose combination (FDC) is a medicine that includes two or more active ingredients combined in a single dosage form. Terms like "combination drug" or "combination drug product" can be common shorthand for a FDC prod ...
consisting of:
FASS (drug formulary)
A formulary is a list of pharmaceutical drugs, often decided upon by a group of people, for various reasons such as insurance coverage or use at a medical facility. Traditionally, a formulary contained a collection of formulas for the compounding ...
Fotil
Retrieved 2015-02-17
*
Pilocarpine
Pilocarpine is a medication used to reduce pressure inside the eye and treat dry mouth. As eye drops it is used to manage angle closure glaucoma until surgery can be performed, ocular hypertension, primary open angle glaucoma, and to bring abo ...
, a
parasympathomimetic
A parasympathomimetic drug, sometimes called a cholinomimetic drug or cholinergic receptor stimulating agent, is a substance that stimulates the parasympathetic nervous system (PSNS). These chemicals are also called cholinergic drugs because ace ...
*
Timolol
Timolol is a beta blocker medication used either by mouth or as eye drops. As eye drops it is used to treat increased pressure inside the eye such as in ocular hypertension and glaucoma. By mouth it is used for high blood pressure, chest pai ...
, a
beta-adrenergic receptor antagonist
References
{{Reflist, refs=
[{{cite book, last=Basic and clinical science course, title=Glaucoma, year=2011–2012, publisher=American Academy of Ophthalmology, isbn=978-1615251179]
[{{cite book, author1=Myron Yanoff , author2=Jay S. Duker , title=Ophthalmology, year=2009, publisher=Mosby Elsevier, isbn=9780323043328, edition=3rd]
Glaucoma