Eye drops for glaucoma
La Mesa glaucoma treatment
Eye drops for glaucoma
Glaucoma is a slowly progressing disease, affecting the flow of fluid (known as aqueous humor) within the eye. This can cause a spike in pressure inside of the eye, causing damage to the optic nerve, which stops the eye from sending signals to the brain. This is how glaucoma can result in blindness.
However, treatment can help to prevent the damaging effects of glaucoma on vision. One option is eye drops. There are actually several different types of eye drops that can be used for glaucoma, and sometimes more than one is used in combination. How can eye drops help patients with glaucoma?
How do eye drops for glaucoma work?
In general, eye drops for glaucoma reduce the buildup of aqueous humor inside of the eye in one of two ways. They may increase the outflow of the fluid, or reduce the production of it. There are several different categories of eye drops for glaucoma, all of which generally work in one (or both) of these ways. By lowering the amount of aqueous humor building up inside of the eye, these eye drops help to prevent the increase in pressure that can cause damage to the optic nerve.
Eye drops that increase the flow of fluid out of the eye
Prostaglandin eye drops relax muscles in the interior chamber of the eye, helping to increase the outflow of fluid. This type of eye drops only need to be used once per day, which many patients find easier to remember. However, there can also be side effects to the use of prostaglandin eye drops, most commonly changes to the appearance of the iris, eyelashes, and the skin around the eye.
Rho kinase inhibitors are a new class of medications for glaucoma, approved in early 2018. It helps to relax cells in the trabecular meshwork to allow more fluid to flow out. They also help to reduce the pressure in veins in the area, so that fluid can flow out more easily. Rho kinase inhibitors can also be used once daily.
Parasympathomimetics cause the contraction of certain small muscles within the eye. The contraction of certain of these muscles helps to open space in the trabecular meshwork, while others act to decrease the size of the pupil. These medications are rarely used for glaucoma because they tend to cause significant side effects, but they may be helpful in certain cases.
Hyperosmotic agents are not used on a daily basis to treat glaucoma, but can be useful in an emergency when the pressure inside of the eye is very high. They help to remove the excess fluid from the eye to reduce the possibility of significant damage. Hyperosmotic agents pull fluid out of the eye more actively, to quickly reduce the amount of fluid and therefore the pressure inside of the eye.
Eye drops that decrease the production of fluid in the eye
Beta blockers inhibit a certain enzyme in the eye in order to decrease production of fluid. Although local side effects of beta-blockers are minor, they can be absorbed through the eye, and can cause systemic side effects.
Carbonic anhydrase inhibitors also decrease production of fluid inside of the eye. They are available as eye drops, but are also available in pill form. (One such medication, Diamox, can also be used to relieve the symptoms of altitude sickness.)
Eye drops that use both mechanisms of action
Alpha-adrenergic agonists, often known simply as alpha agonists, have a dual mechanism of action. One of the medications in this class uses a certain preservative that breaks down easily, which can be helpful for patients who have allergic reactions to the preservatives used in most eye drops.
Epinephrine also has a dual mechanism of action, decreasing the production of aqueous humor and also increasing the outflow through the trabecular meshwork. It can make narrow-angle glaucoma worse, but can be useful for patients with open-angle glaucoma (the more common form).
Combination eye drops
In some cases, using more than one eye drop is best for controlling glaucoma. There are eye drops available that combine more than one of these types of medications, making it more convenient for patients to use more than one medication simultaneously.
Chula Vista, El Centro, La Mesa glaucoma treatment
While there are also surgical options available that can help to prevent complications of glaucoma, our first line of treatment is generally eye drops. Any surgical procedure can have complications, so it’s preferable to start with a medical treatment first. However, for those patients for whom eye drops are not effective, or those who experience significant side effects, there are surgical options for treating glaucoma.
Our patients receiving Chula Vista, El Centro, and La Mesa glaucoma treatment at California Retina Associates will receive education regarding the use of their prescribed eye drops. If you do experience side effects, it’s important to discuss them with us rather than simply stopping the use of your eye drops. Leaving glaucoma untreated has a high probability of leading to vision loss in the future, and the process is often painless but irreversible. It’s also important for glaucoma patients to be monitored on a regular basis, so that your treatment can be adjusted as necessary.