Glaucoma medication

The goal of currently available glaucoma therapy is topreserve visual function by lowering intraocular pressure(IOP) below a level that is likely to produce further dam-age to the nerve. The treatment regimen that achieves thisgoal with the lowest risk, fewest adverse effects, and leastdisruption of the patient’s life, taking into account the costimplications of treatment, should be the one employed.The more advanced the glaucomatous process on initialpresentation, the lower the target range generally needsto be to prevent further progression. This more aggres-sive target is meant to minimize the risk of progressiveglaucoma damage and vision loss. Once the optic nerveis damaged, it is more likely to incur more damage, andif severe visual loss is present, there is greater impact onthe patient from any additional damage that may occur.An initial reduction in the IOP of 20% from baselineis suggested. However, reduction of IOP to the targetpressure range does not guarantee that progression willnot occur. Therefore, the target pressure range needs tobe constantly reassessed and changed as dictated by IOPfluctuations, optic nerve changes, and/or visual field pro-gression.Medications are divided into several groups based onchemical structure and pharmacologic action. Agents incommon clinical use include:[1][2]

• Prostaglandin analogs

• Parasympathomimetic (miotic) agents, includingcholinergic and anticholinesterase agents

• Carbonic anhydrase inhibitors (oral and topical)

• Adrenergic antagonists (nonselective and selectiveBeta1-antagonists)

• Alpha 2 agonists

• Hyperosmotic agents

1 See also• Glaucoma

2 References[1] Basic and clinical science course (2011–2012). Glau-

coma. American Academy of Ophthalmology. ISBN978-1615251179.

[2] Myron Yanoff, Jay S. Duker (2009). Ophthalmology (3rded.). Mosby Elsevier. ISBN 9780323043328.

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