Prescription medicines to lower the pressure inside the eye (intraocular pressure, or IOP) are used to treat all types of glaucoma. They work either by reducing the amount of fluid (aqueous humor) that is produced by the eye or by increasing the amount of fluid that drains out of the eye. These medicines may be given as eyedrops, as pills, in liquid form by mouth, or through a vein (in emergency situations). In most cases, eyedrops are used first.

In congenital glaucoma, medicines may be used to decrease the pressure in the eyes and reduce the cloudiness of the clear front surface (cornea) of the child's eye. Medicines are usually only used until surgery can be done.

When glaucoma has already caused vision loss, further vision loss may occur even after the pressure in the eye is lowered to the normal range with medicine. Talk to your doctor about the goals of treatment, how long the medicine will be tried, and the possible side effects. Eye medicines can cause symptoms throughout the body.

You will need follow-up visits with your doctor to find out whether your medicine is working as well as it should. You can also discuss any side effects or medicine schedule problems.

In most cases, medicines used to treat glaucoma must be continued daily for the rest of your life.

Medication choices

Medicines that decrease the amount of fluid produced by the eye include:

• Beta-blockers (such as Betagan, Betimol, Ocupress, and Timoptic).
• Adrenergic agonists (such as Alphagan and Propine).
• Carbonic anhydrase inhibitors (such as Azopt, Diamox, and Trusopt).
• Hyperosmotics (such as Osmitrol).

Medicines that increase the amount of fluid that drains out of the eye include:

• Cholinergics (such as Isopto Carpine, Phospholine, and Pilopine).
• Adrenergic agonists (such as Alphagan and Propine).
• Prostaglandin analogs (such as Lumigan, Travatan, and Xalatan).

Some medicines have two different medicines mixed into one bottle. Examples include Cosopt, which contains both a carbonic anhydrase inhibitor and a beta-blocker, and Combigan, which contains both an adrenergic agonist and a beta-blocker.

About your medicines

• Use your glaucoma medicines as prescribed by your doctor. If you need reminders for using your medicines, use alarm clocks or watches, notes on mirrors or tables, and other cues.

  Using Medicine as Prescribed

• Learn how to use eyedrops. This can help reduce side effects. If you notice side effects from your glaucoma medicine, tell your doctor. Your medicine may need to be changed.
• If you have closed-angle glaucoma or you are at risk for it, check with a doctor before taking any over-the-counter medicines. You'll need to avoid medicines that widen (dilate) the pupil, such as certain antihistamines and motion sickness medicines.
• Make sure all your doctors know that you have glaucoma. Tell your eye specialist what other prescription medicines you are taking.
• Learn cost-saving tips for glaucoma. For example, use a measured-dose dispenser.
• Carry a wallet card or other identification that states that you have glaucoma. The card needs to list all medicines you are taking, including glaucoma medicines.