Eye drops for glaucoma and eye pressure

Eye drops for glaucoma are medicines that help stop the disease that leads to vision loss. Let's look at effective glaucoma medications, the rules for their use and indications for use.

Glaucoma is an ophthalmological disease that without proper treatment leads to complete blindness. Glaucoma can occur in a chronic form, in which case the lesion is accompanied by a constant increase in intraocular pressure and disturbances in the outflow of intraocular fluid. This leads to the development of defects in the optic nerves.

The main cause of glaucoma is increased intraocular pressure. Therefore, the main stage of treatment is to reduce eye pressure to normal values. If this is not done, then you can get incurable blindness due to the death of the optic nerves. Eye drops for glaucoma help to lower the pressure and stop the destruction of the optic nerves. According to medical statistics, about 3% of people suffer from glaucoma, and in 15% of blind people, glaucoma has become the cause of blindness. People over 40 years of age are predisposed to the disease, but there is congenital and juvenile glaucoma.

The following medications are used to treat the disease:

• Eye drops to improve fluid drainage inside the eye

These are cholinomimetics, which have a beneficial effect on the natural outflow of fluid and effectively reduce intraocular pressure. Hydrochloric acid solution and Pilocarpine are used for treatment. Eye drops based on cholinomimetics such as Carbacholine and Aceclidine are used only as prescribed by a doctor, as they cause a number of side effects. This group of drugs includes new drugs: Travoprost and Latonoprost, they effectively increase the outflow of fluid through additional pathways of the eye.

• Drops to reduce the production of intraocular fluid

The second group of drugs includes hypotensive eye drops, which include a solution of Betaxolol, Timolol maleate, Proxodalol, Dorzolamide hydrochloride and others. Timolol maleate is popular, which is used to treat all types of glaucoma. Drugs with this substance are released under the name: Arutimol, Okumed, Oftan-Timolol. Proxdolol has similar effectiveness, which must be instilled 2-3 times a day. To effectively reduce intraocular pressure, drugs with several active substances are used, which not only normalize pressure, but also reduce the production of intraocular fluid. Combination drugs of this kind include: Polycarpine, Proxodal, Pilocarpine, Latanoprost, Fotil and others.

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Indications for the use of eye drops for glaucoma

Indications for the use of eye drops for glaucoma are based on the therapeutic properties of the drugs. Eye drops for glaucoma are one of the most important methods of conservative treatment. Drops allow you to reduce and maintain intraocular pressure at a normal level. Chronic increased pressure can lead to atrophy of the optic nerves and complete loss of vision.

• Glaucoma drops are prescribed to treat atrophy of the optic nerve, which is responsible for normal vision. With atrophy of the optic nerves, peripheral vision appears, the picture becomes narrow or tunnel-like. After this, complete blindness occurs.
• The optic nerve contains more than a thousand fibers, some of which die due to increased intraocular pressure. The use of drops helps to reduce pressure in glaucoma at the initial stages. But the drops should be used only according to the schedule drawn up by the doctor.

Treatment and medications should be started at the first symptoms of glaucoma. Due to delay or forgetfulness of patients, the disease begins to progress, which leads to rapid death of the optic nerve fibers. Drops should be used only after consultation with an ophthalmologist, strictly according to the instructions for the drug and with regular examination and measurement of intraocular pressure. This will help maintain clear vision for many years.

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Release form

The form of release of drugs for the treatment of glaucoma is mainly drops. The peculiarity of this form is that after instillation they quickly penetrate to the optic nerves and have a therapeutic effect. Drops carefully care for the eye, protect against redness and dryness. Glaucoma drugs are released in convenient bottles, which make the treatment process not only effective, but also comfortable.

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Pharmacodynamics

Pharmacodynamics of eye drops for glaucoma are the processes that occur with the drug after instillation. Let's consider pharmacodynamics using the example of Isopto®-carpine eye drops.

The drops are antiglaucoma drugs, stimulating muscarinic receptors of smooth muscles. The drug affects the iris of the eye, digestive and bronchial glands, as well as glands of external secretion. The drops cause muscle contraction, which has a therapeutic effect on the work of the optic nerves. If the drops get inside, they can cause problems with the gastrointestinal tract and cause dizziness.

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Pharmacokinetics

Pharmacokinetics of eye drops for glaucoma are the processes of absorption, distribution and excretion of the drug. Let us consider these processes using the drug Isopto®-carpine as an example. When using drops to treat glaucoma or ocular hypertension, 30-40 minutes after instillation, a decrease in intraocular pressure by 25% is observed. The maximum effect occurs after 2 hours and lasts for 4-8 hours. Eye drops have a prolonged release of pilocarpine, which ensures that intraocular pressure is maintained at a normal level throughout the day.

The drug is excreted by the kidneys, and is found in urine as metabolites and unchanged. The drops are not absorbed in the conjunctival sac and do not have a general effect. When treating closed-angle glaucoma, the drops constrict the pupil and cause displacement of the iris.

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Names of eye drops for glaucoma

The names of eye drops for glaucoma make it possible to choose the most suitable drug, find out reviews from other patients about the selected drug or select analogs. All glaucoma drops are distinguished by the mechanism of hypotensive action.

1. Drugs to improve the outflow of intraocular fluid

This category includes Xalatan drops with the active ingredient latanoprost, Isopto®-carpine with pilocarpine hydrochloride, Oftan polycarpine, Polycarpine hydrochloride, Polycarpine, Travatan. A 1% solution of pilocarpine hydrochloride with methylcellulose can be used to treat glaucoma. The drops cause a sharp narrowing of the pupil, which leads to the retraction of the iris from the iridocorneal angle. This allows the eye fluid to flow freely through the drainage system of the eye and reduce pressure. This mechanism of the drug is very important in the treatment of closed-angle glaucoma. The disadvantage of the drugs is their short-term hypotensive effect, which lasts for 6 hours.

Since drops for the outflow of intraocular fluid cause miosis, the pupil constriction remains for the entire duration of the drug's action. This leads to a narrowing of the visual field, due to which objects lose their clear outlines. With prolonged use, eye drops for glaucoma cause dermatitis and allergic conjunctivitis. If such drops are used by young patients, this can lead to retinal rupture.

Eye drops for the outflow of intraocular fluid are divided into pharmacological groups:

• Cholinomimetics are substances of synthetic (carbachol) and plant (pilocarpine) origin. The action of the substances is aimed at narrowing the pupil, which reduces pressure and improves outflow. Cholinomimetics are effective in closed-angle glaucoma.
• Prostaglandins - drugs with this active substance retain their activity for 24 hours. Drops can be used to treat open-angle glaucoma, but cause side effects in the form of swelling, burning in the eyes and redness of the mucous membrane.
• Sympathomimetics – substances affect not only the optic nerves, but also the nervous system. They cause increased blood pressure, abnormal heart rhythms, and reddening of the mucous membrane.

2. Medicines to reduce aqueous humor formation

Eye drops for glaucoma may contain carbonic anhydrase inhibitors, α2-adrenergic receptor agonists and β-adrenergic blockers. Popular drops from this group are: Azopt, Betoptic, Trusopt, Timolol, Arutimol, Niolol, Okuril, Kuzimolol and others. Drops to reduce the formation of aqueous humor are contraindicated for use in corneal dystrophy, bradyarrhythmia, concomitant dry keratitis and bronchial asthma.

Drugs for reducing the production of aqueous fluid are divided into the following pharmacological groups:

• Carbonic anhydrase inhibitors – this group of drugs includes the substances trusopt and azopt. The components block the enzymes of the ciliary body.
• β-blockers - the main active ingredients are timolol and proxodol. The drops are contraindicated for use in patients with heart rhythm disorders and respiratory diseases.
• α 2-adrenoreceptor agonists – substances in this category are: brimonidine and clonilin, i.e. clonidine. The peculiarity of such components is in improving the outflow of fluid and reducing its production.

3. Combination drugs

The drops reduce the production of aqueous humor and improve its outflow. Drops Timpilo, Fotil and Fotil-forte are suitable for the treatment of glaucoma. They are prescribed by an ophthalmologist and are available on prescription.

An effective therapeutic strategy for the treatment of glaucoma is based on the impact on: increased intraocular pressure, decreased vagospasm and perfusion, as well as ensuring normal neuroprotection. The approach to treatment depends on the risk factors for glaucoma progression. Eye drops for glaucoma are a prescription drug that can only be prescribed by a physician. Self-administration of drugs is contraindicated, as this can lead to uncontrolled side effects.

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Xalatan for glaucoma

Xalatan eye drops for glaucoma are an effective remedy with the active ingredient latoprost, which is a synthetic analogue of prostaglandin. The mechanism of action of the drug is based on reducing intraocular pressure by increasing the outflow of fluid from the eye. The effect of the drug is observed 3-4 hours after use, and the maximum therapeutic effect after 8-10 hours. The drops do not affect respiratory functions, intraocular circulation parameters and the cardiovascular system.

• The drops are used to treat increased intraocular pressure, open-angle glaucoma and therapy for increased ophthalmotonus. The drug is used only as prescribed by a doctor. Adult patients are prescribed one drop once a day. It is recommended to instill the drug before bedtime.
• Side effects of Xalatan include minor conjunctival hyperemia, allergic reactions and skin rashes. In rare cases, the drug causes point erosions of the epithelium and increased pigmentation of the iris.
• Eye drops are contraindicated for use in case of allergic reactions to the components of the drug. During pregnancy, Xalatan can be used if the potential benefit of its use is higher than the possible risks to the fetus and the birth process. Drops are not recommended for use during lactation.
• In case of overdose, the drops cause conjunctival hyperemia and mild irritation of the mucous membrane of the eye. In rare cases, the drug causes nausea, vomiting, increased sweating, dizziness, and abdominal pain. Treatment of overdose is symptomatic.
• Xalatan is available in 2.5 ml vials with 0.005% latanoprost solution. The drug should be stored in a dark place at a temperature of 2 to 8 degrees. After opening, the vial can be stored for no more than 30 days and only at room temperature.

Method of administration and dosage

The method of application and doses of eye drops for glaucoma are selected by the attending physician after a complete diagnosis of the disease. The dosage depends on the composition of the drug. Thus, some drops may be prescribed to be instilled 2-3 times a day, 1-3 drops, but stronger drugs are prescribed with a lower dosage, 1 drop no more than once a day.

The therapeutic effect of the use of drugs is observed from the first day of use. The peculiarity of eye drops for glaucoma is that they accumulate their medicinal properties, which allows maintaining intraocular pressure at a normal level even after stopping instillation. Maintaining intraocular pressure within the normal range allows you to cure glaucoma and get rid of problems with vision loss.

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Using Glaucoma Eye Drops During Pregnancy

The use of eye drops for glaucoma during pregnancy is possible only after permission from the attending physician. After instillation into the eyes, some of the ingredients of the drug penetrate into the bloodstream. Active substances can enter the fetus through the placenta, and during lactation - through milk. All this suggests that glaucoma during pregnancy is a very dangerous disease, the treatment of which should be carried out under the supervision of a doctor. But fortunately, glaucoma does not often occur in women of childbearing age. If the disease does appear, then drops are used for treatment. The main danger is that to date there is no reliable data on the effect of drops on the intrauterine development of the fetus.

Let's look at the most common glaucoma medications that are unsafe during pregnancy:

• Beta-blockers - eye drops from this group are dangerous in the early stages of intrauterine development, so they are strictly prohibited to use in the first trimester of pregnancy. If a woman uses drops with beta-blockers in the second and third trimester of pregnancy or during lactation, this can cause a decrease in the heart rate and a decrease in the blood sugar level of the child. In addition, the drops can cause a violation of the natural contractions of the uterus, which is very dangerous during pregnancy.
• Miotics – cause intrauterine developmental disorders in the first trimester of pregnancy. During lactation, they cause weakness and increased body temperature in the child, and in rare cases, they cause muscle weakness.
• Carbonic anhydrase inhibitors - drops with this substance are considered safe for the unborn child. But if the expectant mother uses tablets with carbonic anhydrase inhibitors for glaucoma, this leads to the development of congenital disorders in the baby.
• Prostaglandins – can cause premature birth. If the drops are used during lactation, they are excreted in breast milk and cause adverse reactions in the child.

In case of glaucoma during pregnancy and lactation, it is recommended to avoid any medications. The doctor should select the safest ways to reduce intraocular pressure for the health of the expectant mother and her child. If drops are used, it is recommended to instill low doses to avoid possible side effects. Glaucoma does not affect conception and pregnancy, but the drops used for treatment, getting into the mother's body, can lead to unwanted side effects.

Contraindications to the use of eye drops for glaucoma

Contraindications to the use of eye drops for glaucoma are based on the composition of the drug and the action of its active components. Drops are contraindicated for use in case of hypersensitivity to the components of the drug, in case of exacerbations of bronchial asthma, conditions after ophthalmological operations and in case of a high risk of retinal detachment.

Eye drops for glaucoma are contraindicated for instillation in chronic lung diseases, heart failure, cardiogenic shock, sinus bradycardia. Many drugs are not recommended for use during pregnancy, lactation and for the treatment of glaucoma in pediatric patients.

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Side effects of eye drops for glaucoma

Side effects of eye drops for glaucoma occur due to non-compliance with the rules of application and dosage of the drug. Most often, drops cause headaches in the periorbital and temporal areas, spasms, blurred vision, lacrimation, dermatitis of the eyelids, etc. If the drug gets inside, it causes sweating, nausea, chills, abdominal pain, difficulty breathing, increased blood pressure and frequent urination.

• Despite the above-described side effects, the drops are well tolerated. The drug causes symptoms of local irritation: conjunctivitis, decreased corneal sensitivity, visual disturbances, keratitis, blepharitis.
• In some patients, eye drops cause adverse cardiovascular reactions: cerebrovascular accidents, bradycardia, arrhythmia, heart failure, and others.
• Eye drops also cause adverse reactions in the respiratory system. The drug can cause bronchospasms, shortness of breath, and respiratory failure.
• With prolonged use, the drops cause fatigue, chest pain, localized rash and urticaria, and increase the symptoms of myasthenia. Many groups of drugs adversely affect the digestive system, causing nausea and gastrointestinal problems.

Overdose

Overdose of glaucoma medications occurs due to prolonged use of drops, failure to comply with the conditions of use and the presence of contraindications to the use of drugs. Overdose symptoms manifest as local allergic reactions, the development of cardiovascular insufficiency and respiratory dysfunction.

Treatment of overdose is symptomatic. In case of gastrointestinal dysfunction, it is necessary to wash the stomach and monitor the heart rate. In case of high blood pressure and respiratory dysfunction, it is recommended to seek medical help.

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Interactions with other drugs

Interaction of eye drops for glaucoma with other drugs is permissible only with the permission of a doctor. With the simultaneous use of drops Timolol and Mezaton, the production of intraocular fluid decreases. But such interaction causes pronounced bradycardia and intracardiac conduction disorders. Very often, a combination of several drugs leads to bradycardia and heart failure.

It is not recommended to use several drops at the same time, as such interaction causes side effects. When prescribing several eye medications for the treatment of glaucoma, it is necessary to observe the time interval so that each of the drugs has its medicinal properties.

Storage conditions

Storage conditions for eye drops for glaucoma are specified in the instructions for the drug. It is recommended to keep eye drops in a place protected from sunlight and out of the reach of children. It is necessary to observe the storage temperature regime. After opening the bottle with drops, they must be stored at a temperature of no more than 25 ° C. Failure to comply with storage conditions leads to the loss of medicinal properties of the drug and is unsafe for use.

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Best before date

The shelf life of eye drops for the treatment of glaucoma is from 24 to 36 months. But this shelf life applies only to a closed bottle of the drug. After opening, eye drops are allowed to be stored from 3 to 30 days. After this period, the drops lose their therapeutic properties and are not recommended for use.

Eye drops for glaucoma are medications that effectively reduce intraocular pressure, improve fluid drainage within the eye and reduce the production of intraocular fluid. Drops can only be used as prescribed by a doctor, since many drugs are available only by prescription and require medical consultation and supervision. Timely use of drops allows you to cure glaucoma and prevent the disease from becoming chronic.

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