Medical therapy to treat glaucoma works to relieve eye pressure, which is a primary cause of pain associated with this disease. Eye pressure is also a leading factor in glaucoma-related vision loss due to its contribution to nerve damage within the eye.
Drs. Lapsi or So administers two main categories of drugs that alleviate pain and prevent further degeneration of vision. Because pain and disease progression is caused by increased intraocular pressure (IOP), treatment works to balance IOP by creating equilibrium of the in and outflow of aqueous humor, a clear fluid that fills the anterior and interior chambers, plus the pupil, of the eye. Therefore, these medications seek to either decrease aqueous humor production or increase the outflow of aqueous.
Drugs aimed at reducing aqueous humor production:
Carbonic anhydrase inhibitors – Carbonic anhydrase inhibitors are generally used for closed-angle glaucoma, and may be administered in emergencies to rapidly reduce pressure inside the eye. When eye drops have failed to release pressure, the oral form of carbonic inhibitors is often used.
Beta-blockers – Beta-blockers have remained the most popular anti-glaucoma agents for the past 20 years due to their safe nature and very high effectiveness. Beta-blockers are most often used to treat open-angle glaucoma. They can be used in combination with other glaucoma drugs, and usually must be taken twice per day.
Drugs aimed at increasing aqueous humor drainage:
Parasympathomimetic (cholinergic) agents – Parasympathomimetics are used to control IOP in closed-angle glaucoma. These eye drops constrict the pupil, which allows for opening the narrowed or blocked angle where drainage occurs.
Prostaglandin analogies – Prostaglandins used in eye drops work by relaxing muscles within the eye, which serves to better allow the outflow of fluids. Prostaglandins are very effective and have been proven to lower IOP by up to 50% on average. These eye drops are also popular among users because they only need to be administered once daily.
Adrenergic agonists – Adrenergic agonists work both by reducing aqueous humor production and increasing drainage. Some forms of the drug can reduce eye pressure by about 20-27%, and may contain neuroprotective properties to aid in possible prevention of retinal nerve cell degeneration.
As with all medications, some side effects may occur. If you experience any irritation, it is important to contact our practice. Remaining consistent with follow-up visits and medication use will help reduce preventable vision loss. If medical therapy fails or side effects become unbearable, surgical options such as Selective Laser Therapy (SLT), and trabeculectomy are also available to treat glaucoma.
Other therapy for glaucoma treatment includes aerobic exercise, which has been proven to lower IOP and some studies show it may improve blood flow to the retina and optic nerve as well. As little as a brisk twenty-minute walk four times per week can significantly lower eye pressure.
