| Glaucoma medication | |
|---|---|
 Latanoprost | |
| Specialty | Ophthalmology |
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.
Agents in common clinical use include: [1] [2]
When comparing people with primary open-angle glaucoma and ocular hypertension, medical intraocular pressure lowering treatment slowed down the progression of visual field loss. [4]
| 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% | bronchospams, bradycardia, depression, impotence |
| Betaxolol | Betoptic | Decrease aqueous production | Every 12 hours | 15-20% | Fewer pulmonary complications due to selective Beta blockage |
| Adrenergic agents | |||||
| Brimonidine | Alphagan | Decrease aqueous production, increase USO | every 8–12 hours | 20-30% | blurring, foreign body sensation, eyelid edema, dryness, headache, fatigue, hypotension, depression, insomnia |
| Miotics | |||||
| Pilocarpine | Isoptocarpine, Pilocar | Increase trabecular outflow | Every 6–12 hours | 15-25% | posterior synechia, keratitis, miosis, brow ache, cataract, myopia, retinal tear, dermatitis, increased salivation |
| Carbonic anhydrase inhibitors | |||||
| Dorzolamide | Trusopt | Decrease aqueous production | Every 8–12 hours | 15-20% | eye irritation, bitter taste |
| Brinzolamide | Azopt | Decrease aqueous production | Every 8–12 hours | 15-20% | eye irritation, bitter taste |
| Acetazolamide | Diamox | Decrease aqueous production | Every 6–12 hours | 15-20% | malaise, depression, weight loss, kidney stones |
Fotil is a combination drug consisting of: [5]
Glaucoma is a group of eye diseases that lead to damage of the optic nerve, which transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of sight" because the loss of vision usually occurs slowly over a long period of time. A major risk factor for glaucoma is increased pressure within the eye, known as intraocular pressure (IOP). It is associated with old age, a family history of glaucoma, and certain medical conditions or medications. The word glaucoma comes from the Ancient Greek word γλαυκός, meaning 'gleaming, blue-green, gray'.
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 measure pressure in millimeters of mercury (mmHg).
Betaxolol is a selective beta1 receptor blocker used in the treatment of hypertension and angina. It is also a adrenergic blocker with no partial agonist action and minimal membrane stabilizing activity. Being selective for beta1 receptors, it typically has fewer systemic side effects than non-selective beta-blockers, for example, not causing bronchospasm as timolol may. Betaxolol also shows greater affinity for beta1 receptors than metoprolol. In addition to its effect on the heart, betaxolol reduces the pressure within the eye. This effect is thought to be caused by reducing the production of the liquid within the eye. The precise mechanism of this effect is not known. The reduction in intraocular pressure reduces the risk of damage to the optic nerve and loss of vision in patients with elevated intraocular pressure due to glaucoma.
Latanoprost, sold under the brand name Xalatan among others, is a medication used to treat increased pressure inside the eye. This includes ocular hypertension and open-angle glaucoma. Latanaprost is applied as eye drops to the eyes. Onset of effects is usually within four hours, and they last for up to a day.
Ocular hypertension is the presence of elevated fluid pressure inside the eye, usually with no optic nerve damage or visual field loss.
Brimonidine is an α2 agonist medication used to treat open-angle glaucoma, ocular hypertension, and rosacea. In rosacea it improves the redness. It is used as eye drops or applied to the skin.
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, gastric and duodenal ulcers, idiopathic intracranial hypertension, neurological disorders, or osteoporosis.
Brinzolamide is a carbonic anhydrase inhibitor used to lower intraocular pressure in patients with open-angle glaucoma or ocular hypertension.
Bimatoprost, sold under the brand name Lumigan among others, is a medication used to treat high pressure inside the eye including glaucoma. Specifically it is used for open angle glaucoma when other agents are not sufficient. It may also be used to increase the size of the eyelashes. It is used as an eye drop and effects generally occur within four hours.
Levobetaxolol is a drug used to lower the pressure in the eye in treating conditions such as glaucoma. It is marketed as a 0.25 or 0.5% ophthalmic solution of levobetaxolol hydrochloride under the trade name Betaxon. Levobetaxolol is a beta-adrenergic receptor inhibitor.
Nicox S.A. is a French ophthalmology company developing treatments to maintain vision and improve ocular health. Nicox is headquartered in Sophia Antipolis, France, and its Chairman and CEO is Michele Garufi.
Ibopamine is a sympathomimetic drug, designed as a prodrug of epinine, used in ophthalmology. It induces mydriasis. It also has been investigated for use in the treatment of congestive heart failure.
Brimonidine/timolol, sold under the brand name Combigan among others, is a fixed-dose combination medication eye drop used for the treatment of glaucoma. It is a combination of brimonidine and timolol.
Primary juvenile glaucoma is a subtype of primary congenital glaucoma that develops due to ocular hypertension and is diagnosed between three years of age and early adulthood. It is caused due to abnormalities in the anterior chamber angle development that obstruct aqueous outflow in the absence of systemic anomalies or other ocular malformation.
Ripasudil, a derivative of fasudil, is a rho kinase inhibitor drug used for the treatment of glaucoma and ocular hypertension.
Micro-invasive glaucoma surgery (MIGS) is the latest advance in surgical treatment for glaucoma, which aims to reduce intraocular pressure by either increasing outflow of aqueous humor or reducing its production. MIGS comprises a group of surgical procedures which share common features. MIGS procedures involve a minimally invasive approach, often with small cuts or micro-incisions through the cornea that causes the least amount of trauma to surrounding scleral and conjunctival tissues. The techniques minimize tissue scarring, allowing for the possibility of traditional glaucoma procedures such as trabeculectomy or glaucoma valve implantation to be performed in the future if needed.
Bimatoprost/timolol, sold under the brand name Ganfort, is a medication for the treatment of certain conditions involving high pressure in the eyes, specifically open angle glaucoma and ocular hypertension. It is available as eye drops.
Brinzolamide/brimonidine, sold under the brand name Simbrinza, is a fixed-dose combination medication used to reduce intra-ocular pressure in adults with ocular hypertension or in those with an eye condition known as open-angle glaucoma. It contains brinzolamide and brimonidine tartrate. It is used as an eye drop.
Secondary glaucoma is a collection of progressive optic nerve disorders associated with a rise in intraocular pressure (IOP) which results in the loss of vision. In clinical settings, it is defined as the occurrence of IOP above 21 mmHg requiring the prescription of IOP-managing drugs. It can be broadly divided into two subtypes: secondary open-angle glaucoma and secondary angle-closure glaucoma, depending on the closure of the angle between the cornea and the iris. Principal causes of secondary glaucoma include optic nerve trauma or damage, eye disease, surgery, neovascularization, tumours and use of steroid and sulfa drugs. Risk factors for secondary glaucoma include uveitis, cataract surgery and also intraocular tumours. Common treatments are designed according to the type and the underlying causative condition, in addition to the consequent rise in IOP. These include drug therapy, the use of miotics, surgery or laser therapy.
Uveitic glaucoma is most commonly a progression stage of noninfectious anterior uveitis or iritis.