Glaucoma Pharmacotherapy – Principles and Practice

Glaucoma is an irreversible disease requiring lifelong treatment. Although various treatment modalities have emerged, topical medications remain the first line of therapy for most cases. Multiple drugs are currently available in the glaucoma armamentarium; hence, knowledge about the mechanisms of action and adverse effects of all the agents becomes essential. With upcoming research and data from various large studies, the guidelines for glaucoma managment have undergone a paradigm shift. However, optimizing the treatment can sometimes be challenging. Since target intraocular pressure is dynamic and highly individualized, the risk of under or overtreatment is significant. Moreover, factors such as the risk-to-benefit ratio in terms of adverse effects, disruption in daily activities, and cost of therapy have to be kept in mind while prescribing medical therapy for glaucoma. The treatment of glaucoma needs to be highly individualized – some eyes may need aggressive treatment, while others may not. This section covers some of the basic yet essential information regarding glaucoma pharmacotherapy and practice patterns.