Glaucoma: eye drops that reduce intraocular pressure

I present you the list of eye drops used in the treatment of glaucoma to reduce intraocular pressure. Drops from increased eye pressure You should appoint an ophthalmologist, familiarize yourself with the instructions for use and prescribe a prescription.

Remember that timely and regular correction of eye pressure is essential to prevent loss of vision.

Treatment of increased eye pressure

Currently, medical treatment of glaucoma is carried out in three main areas:

1. decreased intraocular pressure (ophthalmic antihypertensive therapy);
2. improvement of blood supply to the inner membranes of the eye and the intraocular part of the optic nerve;
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3. normalization of metabolic processes (metabolism) in the eye tissues to affect the dystrophic processes accompanying glaucoma.

The key point in the treatment of glaucoma is the normalization of intraocular pressure, and methods aimed at improving blood circulation and affecting the metabolic processes in the eye are only auxiliary. The well-known therapeutic value is the correct mode of work and life of the patient.

Effect of eye drops in glaucoma

Starting a regular instillation of anti glaucoma drops that lower high eye pressure, the patient should be aware that there are following options for the action of preparations on intraocular pressure:

1. intraocular pressure (IOP) decreases after the first instillation of the drug. When repeated instillations, this effect is regularly repeated;
2. the effect of the drug is not immediately apparent. It is initially weakly expressed, and in the following days it increases with the condition of regular instillation of the drug;
3. resistance (resistance) to the drug exists from the very beginning, and it has no effect on intraocular pressure (IOP);
4. the drug gives the so-called paradoxical effect - after its introduction, the pressure not only does not decrease, but can increase, and sometimes very significantly. Therefore, a diagnostic test is provided for each antiglaucomatous drug.

In this regard, the appointment of drugs that reduce the level of intraocular pressure, is the prerogative of an ophthalmologist who, when choosing a particular drug, takes into account a number of factors. Do not self-medicate, prescribe independently or cancel antiglaucoma drugs or change the frequency of their instillation, without consulting your doctor! By these actions you can cause irreparable harm to your eyes !!!

When appointing antiglaucoma drops, the patient should be observed at the doctor for at least 2-3 weeks. In the future, monitoring of the effectiveness of treatment is conducted at least once every 3 months. It is recommended that the drugs be regularly replaced after 1 to 2 years with appropriate re-control to prevent the development of resistance to them.

Drugs used in the treatment of glaucoma, are divided into two large groups: drugs that improve the outflow of intraocular fluid from the eye, and drugs that oppress the production of aqueous humor.

Watery water is a clear liquid, which is a solution of salts, which is secreted by the ciliary body and passes from the eye into the blood through the vessel's helmets. Watery moisture is secreted by the ciliary body and fills the anterior chamber of the eye. The pressure of watery moisture (which can be affected by pathological changes) on the vitreous also affects the retina - if it rises above normal limits, the tender retina is damaged and a disease known as glaucoma occurs, without treatment leading to blindness.

List of eye drops from glaucoma

Local application

Drops that improve the outflow of intraocular fluid:

Myotics

1. Pilocarpine. "Pilocarpine hydrochloride" 1%, 2%, 4% solutions (Russia, Ukraine), Isopto-Karpin 1%, 2%, 4% (USA), Oftanpilo-Karpin 1% ( Finland) and others.
2. Carbachol. Isopto-carbachol is 1.5% and 3% (USA).

Sympathomimetics

1. Epinephrine. Glaucon 1% and 2% (USA), Epifrin 0.5%, 1% and 2% (USA).
2. Dipivefrin. "Offtan-dipivevephrine" 0.1% (Finland).

Prostaglandins F2 alpha (drugs enhance the uveoscleral outflow pathway)

1. Patanoprost. "Xalatan" is 0.005% (the USA).
2. Travoprost. "Travatan" is 0.004% (the USA).

Drops that depress the production of intraocular fluid

Selective sympathomimetics

1. Clonidine (Clofelin). "Clofelin" 1,125%, 0,25%, 0,5% (Russia).
2. beta-adrenoblockers (Timolol, Timogeksal, Orutimol, etc.).

Preparations of the first choice: Timolol, Pilocarpine, Prostaglandin F2 alpha (Xalatan, Travatan).

Preparations of the second choice: Betaxalol, Brinzolamide, Dorzolamide, Proxodolol, Clonidine, Dipivephrine, and others.

What to drip for an acute attack of glaucoma?

When developingacute attack of glaucomaTo reduce intraocular pressure, therapy is performed:

Local application

1. Instillation of Myotica - 1% solution of Pilocarpine. The following scheme is used: during the first 2 hours 1 drop of the drug is instilled every 15 minutes, during the next 2 hours - every 30 minutes, during the next 2 hours - 1 time per hour. Next, the drug is used 3-6 times a day, depending on the degree of decrease in intraocular pressure (IOP). A similar scheme is used with a positive result of the Pilocarpine test (pupil narrowing with a single, two-fold instillation of the drug). If there is no reaction of the pupil due to ischemia of the iris, continuing treatment with Pilocarpine is impractical and even dangerous.

In addition to Miotik, a 0.5% solution of Timolol is injected 1 drop 2 times a day.

Internal applications

Inside appoint Acetazolamide (Diacarb) to 0.25-0.5 g 2-3 times a day. In addition to systemic inhibitors of Carboangihydraz, a 2% solution of Dorzolamide (Trusopt) 3 times a day or 1% suspension of Brinzolamide ("azopt") 2 times a day can be used.

Inward or intravenously, osmotic diuretics are used (most often 50% solution of Glycerin in a dose of 1.5-2 g / kg is used). If there is insufficient pressure reduction, you can use intramuscular or intravenous loop diuretics (Furosemide 20-40 mg).

2. If, despite the therapy, intraocular pressure (IOP) does not decrease, intramuscularly injected a "lytic mixture": 1-2 ml of a 2.5% solution of Aminazine, 1 ml of a 2% solution of Diphenhydramine or 2 ml (50 mg) Prometazine ("Pipolphen"), 1ml2% solution of Promedol. After the introduction of the mixture should be followed by bed rest for 3-4 hours due to the possibility of development of orthostatic collapse (a sharp drop in blood pressure).

3. Distracting therapy: hot foot baths, salt laxatives, cans, mustard plasters, leeches on the temple area (performed simultaneously with drug therapy). More details can be found on the page ontreatment of glaucoma with folk methods and means.

4. To remove the arisen block and normalize the outflow of intraocular fluid (VGZH) from the posterior chamber to the anterior chamber (ie. e. for cupping, stopping the attack), and also to prevent the development of repeated seizures, necessarily carry out laser iridectomy in both eyes.

If the attack could not be stopped within the first 24 hours, surgical intervention is indicated - surgery - basal iridectomy.

What can not be instilled in glaucoma

Patients with glaucoma and people predisposed to the disease can not be buried in the eyes atropinsoderzhaschie drugs. Also it is necessary to avoid ingestion of preparations containing belladonna.

Source: O.G.G.G. N. Official and traditional medicine. The most detailed encyclopedia. - Moscow: Publishing house Eksmo, 2012.