Definition
Glaucoma is not simply an eye disease; rather it can be defined as a subtle pathological condition that can cause irreversible damage to the optic nerve, responsible for a progressive decrease in sight, up to blindness. Glaucoma is characterized, more often than not, by an increase in intraocular pressure.
open-angle glaucoma → the most common form of progressive loss of vision
closed-angle glaucoma → less common form, which tends to occur suddenly
Causes
What is certain is that the anomalous increase in intraocular pressure is closely related to the damage to the optic nerve that characterizes glaucoma; the increase in blood pressure depends on damage to the outflow systems from the aqueous humor. In narrow-angle glaucoma, the outflow is suddenly blocked.
However, the real reason from which the disease originates is still under study.
- Risk factors: diabetes, migraine, age> 40 years, ocular hypertension, genetic predisposition, prolonged administration of corticosteroids, history of ocular tumors
Symptoms
Unfortunately, in most patients with glaucoma, the disease is diagnosed late, when it is already in the advanced stage: in fact, especially in the open-angle form, glaucoma is asymptomatic in the initial stage.
Closed angle glaucoma can cause impaired vision, eye pain, difficulty focusing, nausea, vomiting.
Information on Glaucoma - Drugs for the Treatment of Glaucoma is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Glaucoma - Glaucoma Medication.
drugs
Among all the diseases that affect the eyes, glaucoma represents the second cause of blindness: for this reason, at the first manifestation of symptoms, an eye examination is absolutely necessary. As we have seen, however, in most cases glaucoma tends to become symptomatic only at an advanced stage; in this regard, periodic sight checks are recommended, especially in people who have already passed the age of 40.
For the treatment of glaucoma, drugs that reduce intraocular pressure are considered first choice: among the most used we cannot forget the beta-blockers, prostaglandin analogues and carbonic anhydrase inhibitors.
Beta-blockers : these drugs are the most widely used for the treatment of open-angle glaucoma; they are particularly useful for lowering intraocular pressure, given that they perform their therapeutic action directly on the aqueous humor, reducing their production. Although beta-blockers may be either taken orally or locally applied, the latter method of use is preferable given the countless side effects of oral administration.
- Betaxolol (eg. Betoptic, Kerlon): instill one or two drops of the drug in the glaucoma eye. Repeat the application twice a day.
- Levobunolol (eg Vistagan): the drug is available in a 0.5% and 0.25% solution. Apply one or two drops in the eye or in sick eyes, in full compliance with the instructions given by the doctor.
- Metoprolol (eg Seloken): apply a drop of product, twice a day.
- Timolol: timolol can be found alone (Blocadren) or in association with other active ingredients, such as travoprost (+ timolol: eg Duo-Trav), brinzolamide (+ timolol: eg Azarga), bimatoprost (+ timolol: es, Ganfort)
Analogues of prostaglandins : these drugs are used to treat glaucoma, even though they are second-line active ingredients, that is to say indicated if the beta blockers cannot be taken by the patient. The PG analogs carry out their therapeutic activity favoring the outflow of aqueous humor, consequently the intraocular pressure tends to normalize. A typical side effect of these substances is the hyperpigmentation of the iris.
- Latanoprost (eg Galaxia, Xalost, Glak): it is recommended to apply a drop in every eye affected by glaucoma, preferably in the morning.
- Travoprost (eg Travatan): instill a drop of drug once a day, possibly in the evening. Do not use under the age of 18.
- Bimatoprost (eg Lumigan): it is used alone or in combination with timolol (eg the aforementioned Ganfort drug). It is recommended to apply a drop in the diseased eye, or in both, once a day, preferably in the morning.
Sympathomimetics : another category of drugs used as a second line for the treatment of glaucoma are sympathomimetics, which mimic, that is, the activity of adrenaline and noradrenaline.
- Brimonidine (eg Alphagan, Combigan, Brimoftal): the drug is a 2-alpha adrenergic agonist, used in therapy for the treatment of glaucoma in order to lower the pressure inside the eye. The drug is used as an alternative to beta-blockers, if the latter were contraindicated for the patient. It is possible for some patients to apply this drug in combination with timolol. Apply the drug two or three times a day.
- Apraclonidine (eg. Iopidine): like the previous one, also apraclonidinarientra in the class of 2-alpha adrenergic agonists. Generally, 0.5-1% eye drops are used to balance intraocular pressure. The most indicated dose as a complementary treatment for the treatment of chronic glaucoma is: 1 drop, three times a day, for a month, using a 0.5% solution.
- Dipivefrina (ex. Propine): compared to adrenaline, this pro-drug seems to be able to cross the cornea faster, and to be activated just as quickly. Instill two drops per day in the affected eye (or both).
- Pilocarpine (eg Dropilton, Piloca C FN, Salagen): in the past, pilocarpine was for a long time the most used drug for the treatment of glaucoma. However, the considerable side effects, given by the application of pilocarpine-based eye drops in the eye, increasingly removed this drug from the most indicated therapies; among the side effects associated with its use, we cannot forget tearing, variations in refractions and conjunctival hyperemia. However, the most used dose for the treatment of glaucoma is 1-2 drops, to be applied directly to the diseased eye in the form of eye drops, 3-4 times a day.
Carbonic anhydrase inhibitors : used as a second line in glaucoma therapy, these drugs exert their therapeutic action by inhibiting the formation of aqueous humor. They can be used both as an alternative to beta-blockers (for patients who are allergic, intolerant or hypersensitive), and as a complement to therapy with the same beta-blockers (if there are no contraindications for the patient).
- Acetazolamide (eg Diamox): besides being used for the treatment of epilepsy, this drug is also indicated for the treatment of glaucoma, for the reduction of intraocular pressure. Apply the product to the drop of a drop in the diseased eye (or in both if suffering from glaucoma) two to three times a day.
- Brinzolamide (eg Azopt). Also available in combination with timolol: (eg Azarga) it is recommended to instill the drug twice a day. If your doctor considers it appropriate, apply the drug three times a day.
- Dorzolamide (eg Dorzostill, Dorzolamide DOC, Trusopt): when used in monotherapy for the treatment of glaucoma, it is recommended to instill the drug 3 times a day. If the patient with glaucoma uses the drug in combination with beta-blockers, apply the product twice a day.
