Glaucoma is treated with drugs, lasers, and surgery, or a combination of the three. This section reviews the medical and surgical aspects of glaucoma management.
Ophthalmologists have a wide variety of medications for treating glaucoma. The drugs slow the production of aqueous, enhance drainage of excess fluid from the eye, or both. By regulating the production of aqueous and/or its drainage from the eye, an intraocular pressure can be achieved that will not cause damage to the optic nerve. These treatments will not restore vision already lost to glaucoma. Rather, they are intended to stop its progress.
There are a number of eyedrops that may be used for glaucoma, and no one particular class of medications is appropriate for all patients. Beta-blocker eyedrops are among the drugs initially used to lower aqueous production. People with certain heart and breathing conditions should be careful using beta-blockers. Prostaglandins, alpha-2 agonists, and carbonic anhydrase inhibitors are other classes of medications that are used. In most cases, glaucoma can be managed with a single drug or drug combination. However, within 2 years after starting drug therapy, most patients need new or additional medications.
All medications have risks and side effects. Patients should maintain their prescription regimens and discuss side effects or problems with their physicians. When purchasing over-the-counter cold, flu, headache, or other drugs, people taking glaucoma medication should discuss their selections with a pharmacist, who can help them avoid potentially dangerous drug interactions.
Patients can reduce side effects by reducing the eyedrop absorption in the blood stream. Patients can do this by closing their eyes and pressing on their tear ducts (near bridge of the nose) for 3-5 minutes after instilling eyedrops.
Glaucoma and Pregnancy
All available glaucoma medications cross the placenta and are secreted into breast milk during lactation; thus, they have a potential for side effects to the fetus and nursing children. One way to reduce such risks is to minimize all glaucoma eyedrops and choose laser or filtration surgery if intraocular pressure is too high.
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