Glaucoma Drug Treatment
Various forms of glaucoma exist. These are treated with a number of drugs or by an operation. The goal of glaucoma treatment is the lowering of eye pressure, as well as an improvement to the microcirculation and thus, of the blood supply to the eye.
Treatment of the various types of glaucoma occurs predominantly by drug therapy. Several active compounds are used.
- This includes e.g. eye drops which constrict the pupils. Pilocarpine is the oldest drug, which has been used for more than 100 years in the form of eye drops. Pilocarpine causes the muscles responsible for the pupils to contract, resulting in a constriction of the pupils and a widening of the trabecular meshwork, through which the aqueous fluid drains. The improved drainage of fluids from the eye lowers the eye pressure.
- Clonidine is also prescribed as eye drops. It also lowers elevated eye pressure and is used to treat all forms of glaucoma.
- The active compound acetazolamide is used in the form of pills to treat wide-angle glaucoma and also as post-surgery medication.
The currently most frequently prescribed drugs belong to a group of compounds called beta blocker. They lower eye pressure by reducing the formation of aqueous fluid. One example of these beta blockers is timolol, which is used in the form of eye drops. Beta blockers have to be reapplied once or twice daily and have become an integral part of glaucoma therapy.
Further active compounds available for glaucoma treatment are prostaglandins, carbonic anhydrase inhibitors and various combination drugs. It is important that treatment is always finely tuned to each patient’s need.
Prostaglandins are relative newcomers in the treatment of glaucoma. Low doses already show activity and the once daily dose should not be exceeded. Prostaglandins presumably cause a relaxation of the ciliary muscle as well as an improved fluid drainage through the breakdown and conversion of cilial structures. Through this, eye pressure can efficiently be lowered.
Carbonic anhydrase inhibitors act on the enzyme carbonic anhydrase, which is, along with other substances, responsible for the formation of aqueous fluid. If the formation of this enzyme (a protein messenger) is suppressed, production of the aqueous fluid is also reduced. With a decrease in aqueous fluid, eye pressure also is lowered, relieving the optic nerve.