1. Glaucoma: Treatment
Depending upon the type of glaucoma, treatment may include medication, usually prescription
eyedrops, or surgery to lower the pressure in the eye and prevent further damage to the optic
nerve. While there is no cure as yet for glaucoma, early diagnosis and continuing treatment can
The mainstay of glaucoma treatment is to lower the eye pressure, either with the use of eye
drops or surgery. Other eye pressure-independent strategies for glaucoma management are
currently being investigated. These include increasing blood supply to the optic nerves and
providing some form of neuroprotection. However until an alternative is found, lowering the eye
pressure is the only means to reduce the risk glaucoma and visual field loss, and remains the
primary goal of therapy.
A number of medications are currently in use to treat glaucoma, most are usually available in the
form of eyedrops other in the form of pills. A doctor may prescribe a combination of theses
medications or change prescriptions over time to reduce side-effects or provide a more effective
treatment. Typically medications are intended to reduce elevated intraocular pressure and prevent
damage to the optic nerve. Some of these medications include;
For over twenty years, beta-blockers are still the most popular anti-glaucoma agents and they far
surpass any other medication as the first therapy of choice in open-angle glaucoma. Some
examples of Beta blockers includes; Betaxolol (Betoptic), Levobunolol (Betagan) and Timolol
People with asthma, breathing and heart problems should use these treatments with caution as
they may trigger their illnesses. Although beta blockers have proven to be very effective and safe
when used as eyedrops they have several side effects.
Side effects can include low blood pressure, reduced pulse rate, and fatigue. Beta blockers can
also cause a shortness of breath in people who have a history of asthma or other respiratory
disorders. Additionally, beta blockers can change cardiac activity by decreasing the amount of
blood the heart pumps out, which may reduce the pulse rate and/or slow down the heart’s
response rate during exercise. Rare side effects include reduced libido and depression.
Prostaglandin mimetic drugs lowers intraoclular pressure by increasing the uveosclearal outfow of
aqueous humore. Ther ary very effective in reducing the eye pressure and have the advantage of
requiring only once a day administration. The prostaglanding analogs seem to be more effective in
eyes with dark coloured iris. examples include; Xalantan, Rescula, Travatan and Lumigan.
2. Xalantan seems to be emerging as the favoured first line eye pressure reducing drug, while the
others are not as effective.
In initial studies, between 5% and 15% of people who used this medication reported a gradual
change in eye color, due to an increased amount of brown pigment in the iris of the treated eye.
The change in eye color occurs slowly and may not be noticeable for several months to years.
Other side effects can include stinging, blurred vision, eye redness, itching, and burning. These
medications are new to the market, and long term follow up of people who use them is not yet
Alpha adrenergic agonists
These drugs work by both increasing uveoscleral outflow and by decreasing aqueous formation.
They require twice daily administrations to be effective. Examples are Alphagan, Iopindine and
Propine. Alphagan along with reducing eye pressure prevents degeneration of retinal nerve cells
Side effects can include burning or stinging upon instillation of the eye drop, fatigue, headache,
drowsiness, dry mouth and dry nose.
Carbonic anhydrase inhibitors
These act by decreasing intraocular pressure by reducing aqueous formation. Although slightly
less effective than the beta-blockers, these agents are usually well tolerable. If used as mono-
therapy, they may require three-times daily dosing, but twice daily dosing is usually effective
when they are used as adjunctive treatment.
Side effects of the pill form of these medications can include tingling or loss of strength of the
hands and feet, upset stomach, mental fuzziness, memory problems, depression, kidney stones,
and frequent urination. Since eye-drop form of this medication is relatively new, long-term studies
are yet to be completed. Current effects of the eye-drop include stinging, burning and other eye
This is the use of a combination of drugs which works on different receptors. E.g.
Drugs like Combigan is a combination of beta blockers and alpha agonist, while Cosopt is a
combination of beta blocker and carbonic anhydrase inhibitor
Side effects of CombiganTM include the symptoms of beta blockers and alpha agonists. Side effects
of Cosopt® include burning and/or stinging of the eyes and changes in sense of taste. Since these
medications are new to the market, long term follow up of people using these medications is not
Non Prescription Treatments
3. Isokinetic (form of active resistive exercise in which the speed of limb movement is controlled by
a pre-set limiting machine) and aerobic exercise, cause considerable reduction in intraocular
pressure and may be helpful in glaucoma. Aerobic exercise such as a brisk walk for 20 minutes to
raise the pulse by 20% -25%, four times a week (minimum), may inprove blood flow to the retina
and optic nerve as well
Studies have shown in marijuana, when smoked, lowers introcular pressure in people with normal
pressure and those with glaucoma. Further investigations should that marijuana and drugs
derived from marijauna lowered intraocular pressure when administered orally, intravenously also
lowered intraocular pressure but not when topically applied to the eye. However, none of these
studies show that marijuana safely and effectively lower intraocular pressure any more than a
variety of drugs available on the market.
other studies include Meditation and Acupuncture.