Last updated on October 23rd, 2017 at 04:43 am
A lot of treatments for glaucoma are developed to decrease and/or control intraocular pressure (IOP), which can harm the optic nerve that sends visual info to the brain.
Glaucoma eye drops frequently are the first option over glaucoma surgery and can be very reliable at managing IOP to prevent eye damage. If you are an excellent prospect for glaucoma eye drops, you may be recommended more than one type to achieve the best IOP control. In reality, lots of types of these drops can enhance the impacts of other types.
What Is Used to Treat Glaucoma?
Depending upon your general health and other medical conditions, nevertheless, you may be a poor prospect for glaucoma eye drops. This is because medications put in the eye are absorbed into the conjunctival capillary on the eye’s surface area. A certain percentage of the active component of the medication, though small, will get in the bloodstream and might negatively impact functions such as heart rate and breathing.
Similarly, some types of eye drops might aggravate specific existing medical conditions such as asthma. Some glaucoma drugs also can interact with other typical medications such as digitalis, prescribed for heart disease. So make sure you talk about these problems with both your family physician and your optometrist.
Eye Drops to Treat Glaucoma
Glaucoma eye drops are categorized by the active component chemical that assists make the drug work. Also, a lot of the glaucoma eye drops noted here are readily available in generic forms at your drug store.
Prostaglandins. Drugs known as prostaglandins used in eye drops frequently have the best user compliance due to the fact that they are needed just daily. Prostaglandins typically work by unwinding muscles in the eye’s interior structure to enable better outflow of fluids, thus reducing buildup of eye pressure.
These drugs have a few typical side effects, including stinging and burning when put in the eye, eye color change (darkening of the eye) due to a boost of pigmentation in the iris, and extending and curling of the eyelashes. (In fact, the eyelash development side effect ultimately caused the development of an eyelash-lengthening drug called Latisse, which is offered by prescription.)
FDA-approved prostaglandins include Xalatan (Pfizer), Lumigan (Allergan), Travatan Z (Alcon) and Rescula (Novartis). Lots of glaucoma experts now report that prostaglandins have taken the lead in the last few years as a first-line therapy for glaucoma (EyeWorld, January 2007).
Beta-blockers. Used in a range of glaucoma eye drops, beta-blockers were at one time the drugs of first option in dealing with glaucoma. These drugs work by decreasing fluid (liquid) production in the eye and now are often recommended as an adjunct to or in mix with prostaglandins.
These eye drops have the possible to decrease heart rate and might cause unfavorable side effects in people with specific heart issues, lung issues (such as emphysema), diabetes, depression or other conditions. For these factors, ensure you discuss your case history in detail with your eye doctor prior to using beta-blockers.
Examples of beta-blockers used in glaucoma treatment are Timoptic XE (Merck), Istalol (ISTA) and Betoptic S (Alcon).
Alpha-adrenergic agonists. These drugs work by reducing rate of liquid humor production and can be used alone or in combination with other anti-glaucoma eye drops.
Common side effects associated with this category of eye drop consist of red or bloodshot eyes (ocular injection), upper cover elevation, an enlarged (dilated) pupil and itching. The FDA-approved drugs in this class include Iopidine (Alcon), Alphagan (Allergan). and Alphagan-P (Allergan).
Carbonic anhydrase inhibitors. These drugs work by reducing rate of liquid humor production. They are normally used in mix with other anti-glaucoma eye drops and not alone. This category of drug is likewise used in oral form (pills). Typical side effects experienced with this category of eye drop include burning, a bitter taste, eyelid responses and eye soreness (ocular injection).
The FDA-approved eye drops in this class consist of Trusopt (Merck) and Azopt (Alcon). The systemic (tablet) type of carbonic anhydrase inhibitors (CAI) are Diamox (Sigma), Neptazane (Wyeth-Ayerst) and Daranide (Merck, Sharp, & Dohme). About half of patients can not tolerate oral CAIs due to their systemic side effects, that include tiredness, anxiety, loss of appetite, weight reduction, loss of libido, kidney stones, metal taste and tingling in fingers and toes (peripheral neuropathies).
Parasympathomimetics. These drugs work by increasing the outflow of liquid humor from the eye. They are often used to manage IOP in narrow-angle glaucoma. These eye drops cause the pupil to constrict, which assists in opening the narrowed or blocked angle where drainage occurs.
Typical side effects experienced with these types of eye drops include eyebrow ache, pupil constraint, burning, and reduced night vision. FDA-approved drugs in this class consist of pilocarpine, carbachol, echothiophate and demecarium.
Epinephrine. The epinephrine class of drugs has a double effect on the eye. These drugs work by reducing the rate of aqueous humor production and increasing the outflow of liquid humor from the eye.
Typical side effects experienced with this category of eye drop include pigmented eye surface area membrane (conjunctival) deposits, blocked tear ducts and heart palpitations with an increased heart rate. The FDA-approved drugs in this class consist of epinephrine and Allergan’s Propine (dipivalyl epinephrine).
Hyperosmotic agents. These drugs are usually for people with a badly high IOP that need to be lowered instantly before permanent, irreparable damage strikes the optic nerve. Hyperosmotic representatives reduce IOP by lowering fluid volume in the eye.
Normally given just on a one-time, emergency basis, these drugs include oral glycerin and isosorbide orally, and mannitol and urea intravenously.
Mix glaucoma drugs. Study results show that half of people with glaucoma require more than one type of medication to manage IOP. For this factor, a couple of ophthalmic pharmaceutical companies have actually produced “combination” eye drops that can consist of two various anti-glaucoma medicines in the exact same bottle.
For benefit, your eye doctor might recommend combined IOP-lowering medications. Generally, these integrated medications have the additive impact of decreasing IOP. Examples of FDA-approved medications of this type consist of Cosopt (Merck), Combigan (Allergan) and DuoTrav (Alcon).
Investigational Glaucoma Treatments
While some experimental glaucoma medications check out brand-new methods of managing IOP, other treatments are directed at protecting the optic nerve (neuroprotection) to avoid eye damage, potential vision loss and even blindness.
Numerous continuous scientific studies are trying to find neuroprotective agents that may benefit the optic nerve and specific retinal cells in glaucoma. Much of these representatives were established from the outcomes of work done on other main nervous system illness such as Parkinson’s and several sclerosis.
Some investigational treatments are undergoing FDA clinical trials to prove safety and efficiency.
Other potential glaucoma treatments are strictly in experimental stages and may be years far from the possibility of being readily available on the marketplace.
See also: Complete List of Eye Diseases
Examples of neuroprotective representatives under examination for treatment of glaucoma consist of:
- Namenda (memantine). As of late 2010, Allergan had made no announcements relating to future prepare for developing Namenda as a possible treatment for protecting the optic nerve from glaucoma damage. The drug underwent late-stage FDA medical trials as a possible glaucoma treatment, but reportedly did not show considerable advantage for patients.
Namenda originally was FDA-approved in 2003 for its neuroprotective effects in the treatment of Alzheimer’s.
- Copaxone (glatiramer acetate). Copaxone is an injectable drug presently used to treat patients with several sclerosis. Developed by Teva Pharmaceuticals, the drug likewise is being examined as a possible neuroprotective agent to avoid damage to the optic nerve from the effects of glaucoma. Copaxone appears to secure the optic nerve from the direct poisonous effects on afferent neuron triggered by increased IOP.
- Gingko biloba. Some research study results show that the herb gingko biloba may use some protective result for the optic nerve, which can be damaged by glaucoma. A small research study reported in the February 2003 problem of Ophthalmology showed that some people enhanced their ability to see a broader visual field following treatment with gingko biloba.
Other investigational treatments for glaucoma, targeted at controlling high IOP, include:
- Latanoprost Punctal Plug Delivery System. During earlier FDA medical trials, this drug delivery system by QLT Inc. included placing a small punctal plug into a drainage channel in the eye. During a 12-week period, the drug slowly was released to control high intraocular pressure associated with glaucoma.
Early investigations initially revealed the system may have prospective as a drug delivery device. However at this time, the company is working on a different design to assist enhance results.
This drug delivery technique potentially could address issues with compliance amongst individuals who need to use eye drops daily.
- Nanoparticles. University of Central Florida scientists have reported promising arise from experiments using laboratory-created nanoparticles to provide a compound able to block enzymes that develop carbon dioxide, which contributes to the accumulation of internal eye pressure related to glaucoma. Investigations into this method to treating glaucoma remain in really early stages.