When your specialist prescribes drops for your glaucoma treatment, you should use them forever. Unlike antibiotics, it is not a course of treatment. There are four main groups of glaucoma eye drops.
Prostaglandin analogues (latanoprost, travoprost, bimatoprost & tafluprost)
The patient should use them once daily at night. They are the most effective of all glaucoma drops. They have few side effects and are well tolerated. They make the eyelashes grow longer and thicker. They also can cause some colour change in the iris or the skin around the eye.
These drops are used twice daily. They were the gold standard drops until scientists discovered the PGAs in 2001. They are effective and are usually the second line. If you need more than a PGA to control the IOP, it is usual to co-prescribe the PGA and Beta-blocker in a single bottle. This makes it easier and more convenient for you to take your treatment. This is used twice daily. Patients with asthma or slow heart rates cannot usually have beta-blockers. It is important that you tell us if you have these conditions at your consultation.
Ophthalmologists use Iopidine at the time of glaucoma laser treatments. It works fast, but the effect does not last long. Brimonidine lasts much longer as it is used as the third line drop in glaucoma. It is effective. It can make the eye red even after some months of use with some patients developing an allergy to it. In these cases, the patient should stop using the drop, and the redness will resolve.
Carbonic anhydrase inhibitors
The patient uses Dorzolamide and Brinzolamide 2-3 times a day. They are prescribed in combination with beta blockers in a single bottle.
If you have any questions about your drops or the schedule for taking them, please ask. It can be confusing when you start drops or if you must change them.
Regular lifelong follow-up is crucial in monitoring glaucoma and the effects of the treatment. You will not be aware if your glaucoma is getting worse until the disease is in its end stage. This will limit the treatment options. Eye pressure checks, optic disc scans and visual field tests are the gold standard follow-up tests for all glaucoma patients.