Everything You Need to Know About Glaucoma Eye Drops
Key takeaways:
Glaucoma eye drops are a common treatment to help lower eye pressure. They work by lowering the amount of fluid made in the eye, helping fluid to exit the eye, or both.
There are several different brands of eye drops. But prostaglandin eye drops, like Xalatan (latanoprost), seem to be the most effective.
Side effects of glaucoma eye drops can vary between medication classes. Common side effects for all eye drops include eye irritation and swelling.
Glaucoma is an eye condition that causes damage to eye nerves due to high pressure in the eyes. It can cause loss of vision and blindness if left untreated. There are different types of glaucoma. But the most common forms are primary open-angle glaucoma and primary angle-closure glaucoma. Together, these two conditions affect more than 2 million people in the U.S.
Fortunately, there are effective treatments that can help lower eye pressure and prevent further damage from glaucoma. These treatments include glaucoma eye drops, laser therapy, and eye surgery.
Glaucoma eye drops are the most common treatment for glaucoma. This is likely because they’re relatively inexpensive compared to laser therapy and surgery. They’re also effective and generally low-risk for most people. If you have glaucoma, you may be using one or more eye drops to help with your eye pressure.
In this article, we’ll cover what to know about glaucoma eye drops, including how they work and different brands that are available.
How do prescription eye drops treat glaucoma?
Prescription eye drops for glaucoma work by lowering pressure inside the eye. The exact way each eye drop lowers eye pressure can be different, though.
For example, prostaglandin eye drops lower the amount of fluid in the eyes by helping drain it out. This type of eye drop is a first-choice treatment for glaucoma. Prostaglandin eye drops are considered the most effective class of medication for glaucoma. They also only need to be used once daily and don’t usually cause a lot of side effects.
Other classes of prescription glaucoma eye drops include:
Beta blockers: These lower the amount of fluid being made in the eyes.
Alpha agonists: These lower the amount of fluid being made in the eyes and help more fluid flow out of the eyes.
Rho-kinase inhibitors: These also lower the amount of fluid being made and help fluid flow out of the eyes.
Carbonic anhydrase inhibitors: These lower the amount of fluid that’s made inside the eyes.
Cholinergic agonists: These help fluid drain out of the eyes.
Popular glaucoma eye drop brands
There are a few types of glaucoma eye drop brands that your healthcare provider may talk about. Some eye drops even contain a combination of two different types of medications.
Below, we’ll review some of the most popularly prescribed glaucoma eye drops.
Xalatan (latanoprost)
Xalatan (latanoprost) is one of the most frequently prescribed eye drops for glaucoma. It’s an example of a prostaglandin eye drop. These eye drops are usually used once a day in the evening.
Other prostaglandin glaucoma eye drops include:
Lumigan (bimatoprost)
Travatan Z (travoprost)
Zioptan (tafluprost)
Vyzulta (latanoprostene bunod)
Xelpros (preservative-free latanoprost)
Timoptic (timolol)
Timoptic (timolol) is a commonly used beta blocker eye drop. There are also other brands of eye drops that contain timolol, such as Betimol and Istalol. Other available beta blocker eye drops for glaucoma include Betoptic S (betaxolol) and Betagan (levobunolol). These eye drops are typically used once or twice a day.
Alphagan P (brimonidine)
Alphagan P (brimonidine) is the most popular alpha agonist eye drop. The other available eye drop in this class is Iopidine (apraclonidine). These eye drops are usually used 3 times a day.
Rhopressa (netarsudil)
Rhopressa (netarsudil) is a rho kinase inhibitor eye drop. It’s the only medication currently available in this class. It’s recommended to use it once a day.
Trusopt (dorzolamide)
Trusopt (dorzolamide) is a popular carbonic anhydrase inhibitor. The other glaucoma eye drop in this class is Azopt (brinzolamide). These eye drops are recommended to be used 3 times a day.
Isopto Carpine (pilocarpine)
Isopto Carpine (pilocarpine) is a cholinergic agonist eye drop. This is the only eye drop in this medication class that’s used to treat glaucoma. Others are used for different eye conditions. This eye drop may have to be used up to 4 times a day.
Cosopt (dorzolamide/timolol)
Cosopt (dorzolamide/timolol) is an example of a combination eye drop for glaucoma. Combination eye drops contain a mixture of two medications from different classes. For example, Cosopt contains both a carbonic anhydrase inhibitor and a beta blocker.
Combining eye drops that work a little differently can help further lower eye pressure more than just using one eye drop alone. This is helpful if one medication isn’t able to get your eye pressure low enough by itself. The dosing instructions for these vary between eye drops. So be sure to carefully read your prescription label.
Other combination glaucoma eye drops include:
Combigan (brimonidine/timolol) — an alpha agonist and a beta blocker
Rocklatan (netarsudil/latanoprost) — a rho kinase inhibitor and a prostaglandin
Simbrinza (brinzolamide/brimonidine) — a carbonic anhydrase inhibitor and an alpha agonist
Individual glaucoma eye drops can also be prescribed together to provide the same benefits as a combination eye drop. If this is the case, your healthcare provider will write two separate prescriptions for you.
Should you take glaucoma eye drops at night?
Many glaucoma eye drops require more than one dose per day. So, you’ll likely use at least one dose in the evening.
You should try to avoid using beta blocker eye drops at night. This is because research suggests they’re less effective if used at night. If you’re using a beta blocker drop twice a day, it might be helpful to use your evening dose of drops a few hours before you plan to go to bed. If you’re only using it once a day, it’s best to use it in the morning if possible.
Prostaglandin eye drops are usually taken once a day and should be taken at night. This is because research suggests that prostaglandin eye drops can better control eye pressure if used at bedtime.
Are any glaucoma eye drops available over the counter?
No. There are no glaucoma eye drops over-the-counter (OTC). All of the eye drops that are safe and effective for treating glaucoma are prescription-only. Your healthcare provider may recommend OTC products, like artificial tears, to help with certain symptoms. These drops don’t lower the pressure in your eyes. But they can help with other common eye problems like dry eye or eye irritation.
What are some side effects of glaucoma eye drops?
Each class of glaucoma eye drops has a slightly different set of side effects. But, there are some side effects that are common to all the classes. For example, eye irritation and inflammation (swelling) are a possible side effect of all glaucoma eye drops.
Here’s a list of some of the possible side effects for each class of glaucoma eye drops:
Side effects of eye drops like Xalatan
Headaches
Eyelash growth
Color change of the eyes or of the skin around the eyes
Side effects of eye drops like Timoptic
Low heart rate or blood pressure
Trouble breathing or exercising
Crusty eyelashes
Headache
Dizziness
Side effects of eye drops like Alphagan P
Dry mouth and nose
Low blood pressure
Headache
Feeling tired or sleepy
Feeling like there’s something in your eye
Blurry vision
Small white patches inside your eyelids
Side effects of Rhopressa
Pain when applying eye drops
Bleeding in the eyes
Red eyes
Deposits (white or discolored spots) on the cornea
Side effects of eye drops like Trusopt
Metallic or bitter taste right after a dose
Blurry vision
Side effects of Isopto Carpine
Pain around the eyebrows
Worse vision or nearsightedness
Trouble focusing on objects at different distances
Blurry vision
What is the safest eye drop for glaucoma?
All eye drops available for glaucoma are considered safe and effective. The choice may come down to personal preference and cost. But, glaucoma eye drops like Xalatan (prostaglandins) seem to be the best tolerated for most people. This, along with their once-daily dosing, make prostaglandin eye drops a go-to first choice.
Can glaucoma be cured with eye drops?
No, eye drops can’t cure glaucoma. They also can’t restore any vision loss you’ve experienced. But, glaucoma eye drops can help lower your eye pressure and keep your condition from worsening.
The bottom line
Prescription eye drops are a common and effective treatment to lower eye pressure for people who have glaucoma. These eye drops don’t cure glaucoma, but they can keep it from getting worse. There are several different glaucoma eye drop brands. These include prostaglandins, beta blockers, and alpha agonists.
Prostaglandins, like Xalatan and Lumigan, are the most commonly used eye drops for glaucoma. They’re also the most effective. Some common side effects of glaucoma eye drops include eye irritation, eye inflammation, and eye swelling. If you have glaucoma, your healthcare provider can help find the best treatment for you.
Why trust our experts?
References
Alm, A., et al. (1995). Effects on intraocular pressure and side effects of 0.005% latanoprost applied once daily, evening or morning. Ophthalmology.
Gedde, S. J., et al. (2021). Primary open-angle glaucoma preferred practice pattern®. American Academy of Ophthalmology.
Glaucoma Research Foundation. (2020). A guide to glaucoma medications.
Gupta, D., et al. (2016). Glaucoma. American Family Physician.
Li, T., et al. (2016). Comparative effectiveness of first-line medications for primary open angle glaucoma – a systematic review and network meta-analysis. Ophthalmology.
National Eye Institute. (2021). Glaucoma medicines.
Sun Pharmaceutical Industries, Inc. (2021). Xelpros [package insert].
