Glaucoma meds

woodstock

woodstock

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I'm curious if any docs here know what the distinguishing features of different glaucoma eyedrops might be.

I'm taking a guess that most of them act to help suppress the production of fluids (to give the eye a chance to drain/absorb and thus reduce IOP) but are there any drugs which act as the DRANO so to speak?

IE help with absorption itself, help with "boring holes" through the clogged sink? That's a bad analogy - but what do the various drugs do? If the sink is fully clogged, shutting down the water to a trickle might not do a heck of a lot.

Thanks.
 
Doggtyred said:
THC is supposed to enlarge the passageways, but that opens up a whole new can of worms..
Click to expand...

Yeah, if you carry too much of your 'eye drops' around, you may have to talk to those guys:

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woodstock said:
I'm curious if any docs here know what the distinguishing features of different glaucoma eyedrops might be.

I'm taking a guess that most of them act to help suppress the production of fluids (to give the eye a chance to drain/absorb and thus reduce IOP) but are there any drugs which act as the DRANO so to speak?
Click to expand...

Yes !

Beta blockers (e.g. Timolol) and carbonic anhydrase inhibitors (e.g. Trusopt) work to reduce production.
The prostaglandin inhibitors (e.g. Xalatan) increase outflow.
Alpha-Agonists (e.g. Alphagan) increase outflow and decrease production.

By having a number of different pharmacologic mechanisms to achieve the target you have the option of combining medications for increased effect.
 
What you are describing is a mitomycin C trabeculectomy. It's a surgical procedure in which an antimetabolite is applied to the "regrowth matrix" so that it doesn't scar down.....the drain stays open.
 
Thanks everyone

I learned the answer at the eye doc the other day. Mostly because the initial drops he had me on weren't working (combigan). I am now also on Travatan Z.

I have had two trabs Dr. B. They were long enough ago that I haven't used glaucoma eye drops in over ten years. The last one finally scarred shut and he doesn't want to do a third on me, so we are trying to find drops that will work. In the past, iopidine did the trick, and cosopt/truspot IIRC. No probs - worked fast. The combigan did next to nada. I was still 30 while we were figuring out what else to do.

What he was worried about was possible neovascularization, but so far so good. My eye was reliably sub-10 for years after the last trab when all of a sudden it starting shooting up - jumped to 18, then 24, then 30 and combigan wasn't doing anyhting.

I remember timolol too, vaguely. Back before the trabs they had me on all sorts of things.
 
I recall your situation now. I wish there were something obvious.....you opthal. would have thought of it.

If you're anyplace near Wilmer Eye Inst. (Hopkins), seek out Ingrid Zimmer Galler, who is on faculty there.
 
Some of the side effects are interesting. Lumigan can make eyelashes grow long. Now also being prescribed for that purpose. I also used Alphagan-P (SP?) in one eye until about a year ago. It seems to have left that eye permanently sensitive and subject to feeling irritated. Combination of Lumigan and Cosopt seems to be doing the job forrme.
 
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