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Treating glaucoma

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Eyesight is a wonderful gift that no one ever wants to lose. Glaucoma is an ocular disease that can significantly affect vision if it is not taken care of. Thankfully, effectively treating glaucoma can preserve your eyesight longer.

Le traitement du glaucome

More information about glaucoma 

Your field of vision allows you to see not only what is in front of you, but also to the sides. This faculty is essential when, for example, you are driving a car. Glaucoma is an eye disease that is caused by an inadequate outflow of the fluid found in the eye (aqueous humour). This leads to a surplus of fluid, which increases pressure on the optic nerve, the part of the eye that conveys images to the brain and allows us to see.

Because the initial cause of glaucoma is increased eye pressure, the medications that treat the condition target this particular aspect. There are two major classes of medications:

  • those that reduce the production of aqueous humour;
  • those that increase its outflow.

These medications, which come in the form of eye drops, are preferably administered before major symptoms, such as loss of field of vision, begin to affect the patient. Indeed, treatment can stop the disease from further developing, but does not restore lost vision, which is why it is vital to detect it in its early stage.

Medications that reduce the production of aqueous humour

Through different mechanisms of action, these medications all lead to the same result, i.e. decreased production of aqueous humour. Consequently, even with poor outflow, pressure on the optic nerve is reduced since there is less fluid in the eye. Here are the drops available on the market for this purpose.

Table 1: Medications that reduce the production of aqueous humour

Class of medication Medicinal agents
Beta blockers Timolol (TimopticMD, Timoptic XEMD)
Levobunolol (BetaganMD)
Betaxolol (BetopticMD, Betoptic SMD)
a2-adrenergic agonists Brimonidine (AlphaganMD, Alphagan PMD)
Apraclonidine (IopidineMD)
Carbonic anhydrase inhibitors Brinzolamide (AzoptMD)
Dorzolamide (TrusoptMD)

Medications that increase the outflow of aqueous humour

In the same way as the first category of medication, the objective of this second class is to reduce pressure on the optic nerve. There are drainage vessels in the eye that allow aqueous humour to flow normally every day; this class of medication acts by improving them.

Table 2: Medications that increase the outflow of aqueous humour

Class of medication  
Prostaglandin analogs Latanoprost (XalatanMD)
Travoprost (Travatan ZMD)
Bimatoprost (Lumigan RCMD)
Parasympathomimetics Pilocarpine
Carbachol
Adrenergic agonists Dipivefrine

Prostaglandin analogs are the most prescribed. The other two classes of medication are generally used when pressure in the eye stays elevated despite the correct use of other glaucoma drops.

Combination medications, which contain both categories of medications, are also available. These combinations make it easier to administer drops. They are also used when first-line treatments alone are not enough. Here are the formulas that are available:

  • AzargaMD;
  • CosoptMD;
  • CombiganMD;
  • XalacomMD;
  • DuotravMD.

Tips for using glaucoma drops

To prevent significant loss of vision due to glaucoma, ophthalmic drops must be used correctly for the treatment to work. Here are some important tips to follow:

  • Put in your drops every day at the same time.
  • Use the technique taught by your pharmacist to put drops in your eyes.
  • Don’t put more than one drop in your eye at a time.
  • Wait at least 5 minutes between each drop.
  • Press the corner of your eye for 3 to 5 minutes (or for as long as possible) after putting a drop (solution or suspension) in your eye.
  • Discard your drops after the number of days indicated after opening the bottle to avoid eye infections (usually 30 days, but sometimes more, depending on the medication).

In short, glaucoma can be managed by using ophthalmic drops consistently and thoroughly. However, surgery can also be an option in some cases. Early detection of glaucoma through annual visits to your optometrist is essential to stop the degeneration of the optic nerve and preserve your eyesight for as long as possible. Your pharmacist is a precious ally to help you manage your drug treatment for glaucoma; he or she can review basic guidelines with you, as well as ensure that your prescribed treatment is the best and safest for you. The consequences of vision loss can be serious, so keep an eye… on your eyes!

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