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Glaucoma medications
Glaucoma
Key Points
- •Prostaglandin analogues are the first-line medical therapy for glaucoma - 25–35% IOP reduction, once daily dosing, and the best efficacy-to-side-effect ratio of all classes.
- •Beta-blockers (timolol) are the most common second-line agent but are contraindicated in asthma, COPD, and heart block - use betaxolol (selective beta-1) as a safer alternative.
- •Nasolacrimal occlusion for 2–5 minutes after drop instillation reduces systemic absorption by 50–65% - essential for beta-blockers to minimise cardiac/respiratory side effects.
- •BAK (benzalkonium chloride) preservative in most glaucoma drops causes dose-dependent ocular surface disease in up to 60% of chronic users - prefer preservative-free formulations.
- •The OHTS, EMGT, UKGTS, and CNTGS trials collectively prove that IOP reduction (by any modality) prevents or slows glaucomatous progression.
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- Definition
- Epidemiology
- Aetiology and causes
- Pathogenesis
- Classification
- Risk factors and associations