April 20, 2018 Conference


How do I choose a glaucoma medication?

Dr. Kimberly Miller (Presenter)

Pharmacologic therapy is a mainstay of glaucoma treatment.  Prostaglandin analogs have excellent ocular hypotensive properties, have very rare instances of systemic side effects, and offer once daily dosing schedules that could increase compliance.  However, they can have cosmetic side effects that may be undesirable in cases of monocular therapy.  Beta-blockers are effective and safe, but cardiopulmonary side effects can be a concern for some patient populations.  Carbonic anhydrase inhibitors also lower intraocular pressure, but must be dosed twice daily, and have an unfavorable pH which can limit compliance in sensitive patients.  Alpha adrenergic agents are also effective, but produce a high rate of allergy.  Combination agents (Cosopt, Combigan, Simbrinza) can increase compliance and decrease the preservative load on the eye.