Eye drops for glaucoma and eye pressure

Eye drops for glaucoma are drugs that can stop the disease, leading to loss of vision. Consider effective drugs for glaucoma, the rules for their use and indications for use.

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

The main cause of glaucoma is increased intraocular pressure. Therefore, the main stage of treatment is the reduction of eye pressure to normal levels. If this is not done, then you can get incurable blindness due to the death of the optic nerves. Eye drops with glaucoma help reduce 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 caused blindness. People over 40 are predisposed to the appearance of the disease, but congenital and juvenile glaucoma can also occur.

For the treatment of the disease using these drugs:

• Eye drops to improve the outflow of fluid inside the eye

These are cholinomimetic drugs, which favorably affect the natural outflow of fluid and effectively reduce the intraocular pressure. For treatment using a solution of hydrochloric acid and pilocarpine. Eye drops based on such cholinomimetics as Carboholin and aceclidine are used only on prescription, 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 the additional ways of the eye.

• Drops to reduce the production of intraocular fluid

The second group of drugs include antihypertensive eye drops, which include Betaxolol solution, Timolol maleate, Proxodalol, Dorzolamide hydrochloride and others. Timolol maleate, which is used to treat all types of glaucoma, is popular. Preparations with this substance are produced under the name: Arutimol, Okumed, Oftan-Timolol. Proxdolol, which needs to be instilled 2-3 times a day, has similar efficacy. 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. This kind of combination drugs include: Polycarpine, Proksodol, Pilocarpin, Latanoprost, Fotil and others.

[1], [2]

Indications for use of eye drops in glaucoma

Indications for use of eye drops in glaucoma is based on the therapeutic properties of the drugs. Eye drops for glaucoma is one of the most important methods of conservative treatment. Drops allow you to reduce and maintain normal intraocular pressure. An increase in pressure of a chronic nature can lead to atrophy of the optic nerves and complete loss of vision.

• Drops for glaucoma prescribed for the treatment of optic nerve atrophy, which is responsible for normal vision. When atrophy of the optic nerves appears peripheral vision, the picture becomes narrow or tunnel. After this comes complete blindness.
• There are over a thousand fibers in the optic nerve, some of which die due to increased intraocular pressure. The use of drops helps to reduce the pressure in glaucoma in the initial stages. But it is necessary to apply drops only according to the schedule drawn up by the doctor.

It is necessary to begin treatment and apply drugs at the first symptoms of glaucoma. Due to delay or forgetfulness of patients, the disease begins to progress, which leads to the rapid death of optic nerve fibers. It is necessary to apply drops only after consultation with the ophthalmologist, strictly according to the instructions of the preparation and with regular inspection and measurement of intraocular pressure. This will preserve clear vision for many years.

[3], [4]

Release form

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

[5]

Pharmacodynamics

Pharmacodynamics of eye drops in glaucoma is a process that occurs with the drug after instillation. Consider pharmacodynamics using the example of Isopto®-carpine eye drops.

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

[6], [7], [8], [9], [10],

Pharmacokinetics

The pharmacokinetics of eye drops in glaucoma are processes of absorption, distribution and removal of the drug. Consider these processes on the example of the drug Isopto®-karpin. When using drops for the treatment of glaucoma or ocular hypertension, 30–40 minutes after instillation, the intraocular pressure is reduced by 25%. The maximum effect occurs after 2 hours and lasts for 4-8 hours. Eye drops have a prolonged release of pilocarpine, which ensures the maintenance of intraocular pressure at a normal level during the day.

The drug is excreted by the kidneys, is found in the urine as metabolites and unchanged. Drops are not absorbed in the conjunctival sac and do not have a general effect. In the treatment of angle-closure glaucoma, the drops narrow the pupil and cause displacement of the iris.

[11], [12], [13],

Names of eye drops for glaucoma

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

1. Preparations for improving the outflow of intraocular fluid

In this category are Xalatan drops with the active ingredient latanoprost, Isopto®-carpine with pilocarpine hydrochloride, Oftan polycarpine, Polycarpine hydrochloride, Polycarpine, Travatan. For the treatment of glaucoma, 1% solution of pilocarpine hydrochloride with methylcellulose can be used. Drops cause a sharp constriction of the pupil, which leads to a delaying of the iris from the iris-corneal angle. This allows the ophthalmic 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 angle-closure glaucoma. The lack of drugs is their short-term antihypertensive effect, which persists for 6 hours.

Since drops for outflow of intraocular fluid cause miosis, the pupil constriction persists throughout the duration of the drug. This leads to a narrowing of the field of view, because of this, objects lose their clear outlines. With prolonged use, eye drops with glaucoma cause dermatitis and allergic conjunctivitis. If such drops are used by young patients, this can lead to a retinal rupture.

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

• Cholinomimetics are substances of synthetic (carbachol) and plant (pilocarpine) origin. The action of substances is aimed at constriction of the pupil, which reduces pressure and improves the outflow. Cholinomimetic drugs are effective for angle-closure glaucoma.
• Prostaglandins - drugs with this active ingredient 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. Cause increased blood pressure, heart rhythm disturbances, redness of the mucous membrane.

2. Medicines to reduce the formation of aqueous humor

Eye drops from glaucoma may contain carbonic anhydrase inhibitors, α2-adrenoreceptor agonists, and β-adrenergic blockers. Popular drops from this group: Azopt, Betoptik, Truzopt, Timolol, Arutimol, Niolol, Ocuril, Kuzimolol and others. Drops to reduce the formation of aqueous humor is contraindicated for use in corneal dystrophy, bradyarrhythmias, concomitant dry keratitis, and in bronchial asthma.

Preparations to reduce the production of aqueous liquid are divided into the following pharmacological groups:

• Carbonic anhydrase inhibitors - in this group of drugs are trusopt and azopt substances. Components block the enzymes of the ciliary body.
• β-blockers are the main active ingredients timolol and proxodol. Drops are contraindicated for use in patients with cardiac arrhythmias and respiratory diseases.
• The α 2 -adrenoreceptor agonists are in this category of substance: brimonidine and clonilin, i.e., clonidine. The feature of such components is to improve the outflow of fluid and reduce its production.

3. Combined drugs

Drops reduce the production of aqueous humor and help to improve its outflow. Timpilo, Fotil and Fotil Forte drops are suitable for the treatment of glaucoma. Appointed by an ophthalmologist and dispensed by a medical prescription.

An effective therapeutic treatment strategy for glaucoma is based on the effects on: increased intraocular pressure, reduced vospospasm and perfusion, as well as ensuring normal neuroprotection. The treatment approach depends on the risk factors for the progression of glaucoma. Eye drops for glaucoma is a prescription drug that only a doctor can prescribe. Self-use of drugs is contraindicated, as this can lead to uncontrolled side effects.

[16]

Xalatan for glaucoma

Xalatan eye drops for glaucoma is 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 the reduction of 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. Drops do not affect the respiratory function, parameters of intraocular blood circulation and the cardiovascular system.

• Drops are used to treat elevated intraocular pressure, open-angle glaucoma, and treatment of elevated intraocular pressure. Use the drug only on prescription. Adult patients are prescribed one drop 1 time per day. The drug is recommended to instil at bedtime.
• Side effects of Xalatan appear as minor conjunctival hyperemia, allergic reactions, and skin rashes. In rare cases, the drug causes pinpoint erosion of the epithelium and an increase in iris pigmentation.
• Eye drops are contraindicated for use in allergic reactions to the components of the drug. During pregnancy, Xalatan can be used if the potential benefits of its use are higher than the possible risks to the fetus and the birth process. Drops are not recommended for use during lactation.
• When overdose drops cause conjunctival hyperemia and mild irritation of the mucous membrane of the eye. In rare cases, the drug causes nausea, vomiting, excessive sweating, dizziness, pain in the abdomen. Symptomatic overdose treatment.
• Xalatan is released in 2.5 ml vials with a 0.005% solution of latanoprost. Store the drug should be in a dark place at a temperature of 2 to 8 degrees. Once opened, the bottle can be stored for no more than 30 days and only at room temperature.

Dosage and administration

The method of administration and the dose of eye drops in glaucoma are selected by the attending physician after a complete diagnosis of the disease. The dosage depends on the composition of the drug. So, 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. A feature of eye drops for glaucoma is that they accumulate their medicinal properties, which allows to maintain intraocular pressure at a normal level even after stopping instillation. Maintaining intraocular pressure within normal limits allows you to cure glaucoma and get rid of problems with vision loss.

[17], [18], [19]

Use of eye drops for glaucoma during pregnancy

The use of eye drops in glaucoma during pregnancy is possible only after the permission of the attending physician. After instillation into the eyes, part of the ingredients of the drug penetrates the bloodstream. Active substances through the placenta can enter the body of the fetus, and during lactation - through milk. All this suggests that glaucoma during pregnancy is a very dangerous disease, treatment of which should take place under the supervision of a physician. But fortunately, glaucoma does not often occur in women of childbearing age. If the disease appears, drops are used for treatment. The main danger is that today there is no reliable data on the effect of droplets on fetal intrauterine development.

Consider the most common drugs for glaucoma that are unsafe during pregnancy:

• Beta-blockers - eye drops from this group are dangerous in the early stages of fetal development, so they are strictly forbidden to use in the first trimester of pregnancy. If a woman uses beta-blocker drops in the second and third semester of pregnancy or during lactation, this can cause a decrease in heart rate and a decrease in blood sugar levels in the baby. In addition, drops can cause a violation of the natural contractions of the uterus, which is very dangerous during pregnancy.
• Miotiki - lead to violations of fetal development in the first trimester of pregnancy. During lactation, they cause weakness and fever in the child, in rare cases cause muscular weakness.
• Carbonic anhydrase inhibitors - drops with this substance are considered safe for the unborn child. But if the future 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 must choose the most safe for the health of the future mother and her child ways to reduce intraocular pressure. If the drops are still used, it is recommended to instil low doses to avoid possible side effects. Glaucoma does not affect conception and pregnancy, but drops used to treat drops into the mother’s body can lead to undesirable side effects.

Contraindications to the use of eye drops in glaucoma

Contraindications to the use of eye drops in glaucoma are based on the composition of the drug and the action of its active ingredients. Drops are contraindicated for use in case of hypersensitivity to the components of the drug, with exacerbations of bronchial asthma, condition after ophthalmologic operations and with a high degree of danger of retinal detachment.

Eye drops in glaucoma is contraindicated to instil in chronic lung disease, 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.

[14], [15]

Side Effects of Eye Drops for Glaucoma

Side effects of eye drops in glaucoma occur due to non-compliance with the rules of use and dosage of the drug. Most often, drops cause headaches in the periorbital and temporal areas, spasms, blurred vision, tearing, eyelid dermatitis, and more. If the drug gets inside, it causes sweating, nausea, chills, pain in the abdomen, difficulty breathing, high blood pressure and frequent urination.

• Despite the above 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: disorders of cerebral circulation, bradycardia, arrhythmia, heart failure, and others.
• Eye drops cause adverse reactions on the part of the respiratory system. The drug can provoke bronchospasm, shortness of breath and respiratory failure.
• With long-term use drops cause fatigue, chest pain, localized rash and urticaria, increase the symptoms of myasthenia. Many groups of drugs adversely affect the digestive system, causing nausea and problems with the gastrointestinal tract.

Overdose

Overdose of drugs for the treatment of glaucoma arises due to the prolonged use of drops, with non-compliance with the conditions of use and in the presence of contraindications to the use of medicines. Overdose symptoms manifest as local allergic reactions, development of cardiovascular insufficiency and impaired respiratory function.

Symptomatic overdose treatment. In case of violation of the functions of the gastrointestinal system, it is necessary to carry out a gastric lavage and monitor the heart rate. With elevated blood pressure and impaired respiratory functions, it is recommended to seek medical help.

[20], [21], [22], [23], [24]

Interactions with other drugs

The interaction of eye drops in glaucoma with other drugs is permissible only with the permission of a doctor. With simultaneous use of drops of Timolol and Mezaton, the production of intraocular fluid decreases. But such an interaction causes pronounced bradycardia and impaired intracardiac conduction. 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, since such an interaction causes side reactions. In the appointment of several ophthalmic drugs for the treatment of glaucoma, it is necessary to observe the time interval in order for each of the agents to have its medicinal properties.

Storage conditions

Storage conditions for eye drops for glaucoma are specified in the instructions of the drug. It is recommended to keep eye drops in a place protected from sunlight and inaccessible to children. It is necessary to observe temperature storage. After opening the bottle with drops, they should be stored at a temperature not exceeding 25 ° C. Failure to comply with the storage conditions leads to the loss of medicinal properties of the drug and is unsafe to use.

[25], [26], [27]

Shelf life

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 vial of the drug. After opening the eye drops are allowed to be stored from 3 to 30 days. After the expiration of this period, the drops lose their therapeutic properties and are not recommended for use.

Eye drops for glaucoma are drugs that effectively reduce intraocular pressure, improve the outflow of fluid inside the eye, and reduce the production of intraocular moisture. It is possible to use drops only on prescription of a doctor, since many drugs are released only by prescription and require medical advice and control. Timely use of the drops can cure glaucoma and prevent the disease from flowing into the chronic form.

[28], [29], [30], [31]