eye_drops

Treatments & Drugs

The most common treatments for glaucoma are eye drops and, rarely, pills. Doctors use a number of different categories of eye drops to treat glaucoma. They either decrease the amount of fluid (aqueous humor) in the eye or improve its outward flow, and some do both. Sometimes doctors will prescribe a combination of eye drops.

People using these medications should be aware of their purpose and potential side effects, which a medical professional should explain. Some side effects can be serious. If you are concerned, call your doctor immediately.

Glaucoma: Treatment Options

Your doctor should help you decide which medications are best suited for you based on your individual case of glaucoma, medical history, and current medication regimen. To help you prepare for a conversation with your doctor, we have created a downloadable guide.

Types of Medications

Medicine, laser treatment, and surgery are all effective for lowering intraocular pressure and preserving sight; however, not all treatments will work equally well for every individual. You and your doctor must decide on a treatment plan that takes into account your type of glaucoma, its severity, how quickly it’s progressing, and other factors.

  • This medication both reduces aqueous humor production and increases its outflow. Allergic reactions frequently occur with this class of medication. 

    Examples include: 

    • Apraclonidine (Iopidine®) 

    • Brimonidine (Alphagan®) 

    • Epinephrine (Gluacon® and Epifrin®)

    • Dipivefrin (Propine®)

  • This type of medication works to lower eye (intraocular) pressure by reducing aqueous humor production and decreasing the rate at which the fluid flows into the eye. 
     
    Examples include: 

    • Timolol (Timoptic XE Ocumeter® and Timoptic®) 

    • Levobunolol (Betagan®)

    • Carteolol (Ocupress®)

    • Metipranolol (OptiPranolol®)

    • Betatoxol (Betoptic®) 

  • In March 2020, the FDA has approved Durysta™, a new long-term, biodegradable eye implant, containing bimatoprost (prostaglandin analog) to reduce eye pressure in people with ocular hypertension or open-angle glaucoma. Durysta™ is currently indicated as a single-use implant, and patients who receive the implant would not be able to be re-administered a second time. 

    The most common side effect involving the eyes reported in patients using Durysta™ was eye redness. Other common side effects reported were: feeling like something is in your eye, eye pain, being sensitive to light, a blood spot on the white of your eye, dry eye, eye irritation, increased eye pressure, a loss of cells on the inner layer of the cornea, blurry vision, inflammation of the iris, and headache.

  • These are eye drops or pills that reduce fluid production in the eye. Examples include: 

    • Dorzolamide (Trusopt®) 

    • Brinzolamide (Azopt®) 

    • Acetazolamide (Diamox®): an oral medication 

    • Methazolamide (Neptazane®): an oral medication 

  • This type of medication is a cholinergic agent, which causes the pupil to become much smaller in diameter and helps increase fluid drainage from the eye.

    Examples include: 

    • Pilocarpine (Isopto Carpine®, Pilocar® and Pilopine HS® ointment)

    • Echothiophate (Phospholine Iodide®) 

  • This medication reduces eye pressure by increasing the outward flow of fluid from the eye.

    Examples include: 

    • Tafluprost ophthalmic solution (Zioptan™) 

    • Latanoprost (Xalatan®) 

    • Bimatoprost (Lumigan®) 

    • Travoprost (Travatan®) 

    • Unoprostone isopropyl ophthalmic solution (Rescula®) 

    • Latanoprostene bunod ophthalmic solution (Vyzulta™) 

    • Netarsudil ophthalmic solution (Rhopressa®)
  • Combinations of eye drops may also be used to achieve better results.

    Examples include: 

    • Dorzolamide and timolol (Cosopt®) 

    • Latanoprost and timolol (Xalacom®)

    • Brimonidine and timolol (Combigan™) 

    • Brinzolamide and brimonidine (Simbrinza®) 

    • Netarsudil and latanoprost (Rocklatan™) 

laser iridotomy

Eye illustrations by Bob Morreale, provided courtesy of BrightFocus Foundation

Laser Therapies

Currently, laser surgery is the most frequently used procedure to treat glaucoma. It normally lowers eye pressure, but the length of time that pressure remains low depends on many factors, including: 

  • Age of the patient 

  • Type of glaucoma 

  • Other medical conditions that may be present 

Many cases still need continued medication but possibly in lower amounts.

anatomyeye_morreale-800

 

Your doctor may use laser surgery to treat open-angle, angle-closure, or neovascular glaucoma. He or she will perform laser surgery on an outpatient basis in the office or clinic after numbing your eye. 

To reduce eye pressure, the doctor directs a laser toward the iris, ciliary body, retina, and trabecular meshwork (tissue near the cornea and iris that drains the aqueous humor from the eye into the blood)

 

surgeons

Surgery 

Eye doctors often use conventional surgical procedures (also called incisional therapies) for glaucoma after other treatment strategies, such as medications and laser surgery, have failed. 

When deciding on a treatment option, an ophthalmologist will take into account the unique aspects of each person's case, including the: 

  • The severity of the disease

  • Response to medication 

  • Other health issues 

 

 
baby smiling

Glaucoma Surgery for Infants

Goniotomy is used almost exclusively for infants with congenital glaucoma. In this procedure, the doctor inserts a tiny blade through the cornea to cut the trabecular meshwork. This procedure allows the eye fluid to flow normally out of the eye. 

Trabeculectomy is also used for infants with congenital glaucoma. The doctor makes an incision in the outer portion of the eye and uses a tiny probe to break through the trabecular meshwork. Eye fluid is then able to drain out of the eye, keeping eye pressure in a more normal range. 

Take Action

Ways to Give

The most valuable assets we have are the individuals dedicated to our cause. People like you are the reason we are able to boost our scientific agenda so that patients’ lives may be enhanced.

Find a Glaucoma Clinical Trial

These studies are crucial to advancing medical approaches most effective for specific conditions or groups of people. Today’s clinical trials will lead to new standards of care in the future. Learn more here.

Donate to National Glaucoma Research

Your gift can help lead to treatments and a cure to end glaucoma. Fund the latest, promising research and help provide valuable information to families living with this disease.

I would like to donate