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There is no one-size-fits-all plan for treating patients with glaucoma. This article takes a look at the most commonly prescribed glaucoma medications and noteworthy attributes that should be considered in their use.
There is only one proven way to halt progression of glaucoma, which is by lowering(intraocular pressure) IOP; fortunately, there are many pharmacologic options available to accomplish this.
Treating each patient as an individual and finding the best recipe for IOP reduction makes glaucoma management an ever-changing and rewarding journey.
Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes.
Prostaglandin analogues are the tried-and-true first-line medication class prescribed to lowerIOP in the treatment of patients with glaucoma.
As a group, the prostaglandins have the advantages that they only need to be put in once per day and are as effective (or more so) than any of the other drugs that most often need doses both morning and night.
These drugs work by increasing uveoscleral outflow. A 5 mm Hg to 8 mm Hg reduction in baseline IOP can be expected, with considerable flattening of the diurnal curve.
Latanoprostene bunod ophthalmic solution 0.024% (Vyzulta, Bausch + Lomb) is a modified prostaglandin analogue with a dual mechanism of action. It breaks down into latanoprost acid and nitric oxide inside the eye.
The latanoprost acid works like other prostaglandins to increase uveoscleral outflow, and the nitric oxide’s mechanism of action is thought to relax the trabecular meshwork to increase aqueous humor outflow.
The drug has the same side effects as other prostaglandin analogues (e.g., redness, pain, lash growth, increased pigmentation of the iris and periorbital area).
Another advantage is the availability of alternatives for patients sensitive to the preservative benzalkonium chloride (BAK).
Care must be taken when these drugs are used in patients who have a history of inflammatory conditions or of recurrent herpes simplex.