Medications for Glaucoma

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Published 2-28-09
Dear Pharmacist, I’ve been taking glaucoma eye drops for 6 years. My vision is still getting worse and I fear going blind. Can you tell me about my medication options so I can ask my doctor which is best for me?  –G.F.  Dallas, Texas
Answer: For the most part glaucoma is an affliction of older adults. Glaucoma is a condition where fluid in the eye does not drain properly, causing excess pressure within the eye. Simply put, chronic high pressure in the eye damages the optic nerve and leads to blindness. About 4 millions Americans have “open angle” glaucoma and the troublesome thing is that you might not know until you’ve lost 40 percent of your vision! This is why regular eye exams are so important. I personally don’t mind eye exams because they’re affordable and blessedly painless, as they involve no needles, gloves or probing fingers. Plus ophthalmologists can discover and treat all sorts of eye conditions and help maintain your eyesight.
There are many causes of glaucoma. Some experts think that tiny clots and debris clog the mesh network in your eye and block drainage of eye fluid. This reminds me of my kitchen sink clogging up, with murky water rising until I hit the disposal button. Prescribed eye drops work by slowing down the rising level of fluid (keeping the sink unclogged and preventing the murky water from building up). This means lower eye pressure and less damage to the optic nerve.
Two older drugs were popular in the 90’s, timolol and betaxolol. These are inexpensive and they suppress the production of eye fluid.  Side effects include slowed heart rate, fatigue and lightheadedness. Newer meds that reduce eye fluid include Iopidine, Trusopt, Azopt and Alphagan P.  Depending on which one you take, these drops might cause stinging, enlarged pupils, itchy red eyes, tearing or dizziness.  People might mistake you for being hungover because of the bloodshot effect. Another odd side effect is a bitter metallic taste in your mouth, especially with Trusopt and Azopt.
Many people love the convenience of using drops once daily. This is why Xalatan, Lumigan and Travatan are so popular. These drugs relax muscles in your eyes so the fluid can naturally drain taking off the pressure. It’s fascinating that these medications can darken your eye color over time and just like mascara, they can lengthen and thicken your eyelashes. For real. The makers of  Lumigan capitalized on this side effect and now sell a prescription eyelash boosting drug called  Latisse. Visit if you don’t believe me.
Cosopt is a convenient combination eye drop that marries Trusopt with Timolol. Other convenient dual-acting drops include Combigan and DuoTrav. For more information on glaucoma research and conventional treatments visit
Did You Know?

The popular diuretic furosemide is a drug mugger of thiamine so you should supplement.