Current glaucoma treatment involves lowering intraocular pressure, preventing further vision loss. If the disease is detected early enough and treatment is started in time, permanent vision loss can be avoided. If no treatment is available, blindness could be the consequence. The choice of therapy depends on the type of glaucoma, the severity of the disease and the side effects of treatment. The treatment may consist of eye drops, tablets, lasers or surgery, either alone or in various combinations. In cases where a glaucoma is detected early, it may be controlled with the help of glasses or contact lenses, laser therapy or eye drops. When the glaucoma cannot be controlled by means of conventional treatment, surgical treatment is applied.

Most glaucoma eye drops help reduce pressure by decreasing aqueous humour production or by increasing outflow through the trabecular meshwork. These drugs may be used to lower eye pressure in patients with glaucoma and to treat ocular hypertension. Drugs may be administered several times daily, at different intervals. Complications of glaucoma therapy include dry eyes, infection of the eye (conjunctivitis), red eyes (irritation of the eye) and allergic conjunctivitis. In general, ophthalmic preparations are only applied in the affected eye. The next eye drop treatment is to be carried out after 15 to 20 minutes, so that the first eye drop will no longer be active in the eye. It is therefore important to check that the first drop has been correctly applied. This can be done by bringing a few drops of tear fluid into the eye with a cotton swab.

Decreasing aqueous humour production

Certain prostaglandin analogues (brinzolamide and latanoprost) are thought to decrease aqueous humour production by decreasing the ciliary body's production of aqueous humour. The exact mechanism is unknown, but it is thought that these drugs stimulate pigmentary dispersion (a process which breaks up pigment in the ciliary body), thereby decreasing production. They also induce venous and arterial vasodilation, causing a decrease in intraocular pressure. In addition, these drugs increase uveoscleral outflow through a mechanical process.

Beta-Blockers (usually timolol, betaxolol, carteolol)

Beta-blockers block production of an eye fluid called aqueousthis lowers IOP. Beta-blockers are often taken twice daily, in the morning and in the evening.

Some information about using the drug Timolol

Like any medicine, timolol can have side effects. The most common side effects are redness, burning, stinging, and itching of the eyes, redness of the eyelids and other areas of the skin near the eyes, tearing, and changes in eye color.

Corticosteroids (such as prednisolone, dexamethasone) corticosteroids help reduce the inflammatory response. Corticosteroids are often used together with beta-blockers and anti-VEGF drugs, but not by themselves. Adverse effects of corticosteroid eye drops can include glaucoma, increased eye pressure, cataracts, and thinning of the eye's cornea.

What is the safest eye drop for glaucoma?

Choosing an eye drop for glaucoma patients is a difficult issue. This question can be broadly divided into the following sub questions which may provide more specific answers: Which is the safest drop (in terms of side effects)?

Which is the most cost-effective drop?

The most important consideration for the patient is the cost of treatment. This varies by country, condition, and health care provider. The best way to find this out is to talk to your glaucoma specialist.

Which is the most convenient drop for the patient?

As glaucoma patients tend to have multiple comorbidities which put them at a higher risk for systemic side effects, all drops, even the safest, should be used with caution.

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