What eye drops are used to treat glaucoma and increased eye pressure

Among the eye diseases associated with increased intraocular pressure pathology occupy a special place, as fraught with the development of serious visual impairments and, in particular, blindness. One of these complications is glaucoma - the most severe consequence of increased IOP, resulting from optic nerve atrophy. The most promising direction in the treatment of this disease is the early diagnosis and use of certain drugs (mainly eye drops) to reduce HP.

Application area

Drops that reduce elevated IOP are effective in the early stages of the disease, when pathological changes can still be slowed down with drugs.Completely cure such a pathology as glaucoma, through conservative treatment is impossible. However, the competent and timely use of a doctor's recommended treatment in conjunction with compliance with certain rules of general order is able to slow down progress for many years disease.

In other cases, when drug therapy is ineffective or the disease is detected at a late stage, the only way out is surgery.

The detection of glaucoma at an early stage is the most important factor in successful treatment. Therefore, it is necessary to imagine what causes can trigger the development of pathology:

• Constant eye strain;
• High blood pressure (hypertension);
• Violation of the endocrine system (in particular, the thyroid gland);
• Heart or kidney failure;
• Nervous system disorders;
• Development of tumors (different properties);
• Post-traumatic complications;
• Viral and other infections of the respiratory department;
• Vegetosovascular dystonia;
• Use as a medicine of steroid drugs for a long period;
• The development of the inflammatory process directly in the eyes or adjacent tissues.

Treatment of glaucoma at an early stage involves regular (1 time in 3 months. ) visits to the ophthalmologist, as well as the continuous use of recommended medications.

Features of preparations

At the initial stage, the doctor selects the drug most suitable for the patient and monitors the dynamics of IOP changes during examination. All drugs are divided into several groups, depending on the degree of exposure:

• Preparations of the first choice.Appointed at the beginning of therapy and characterized by a decrease in intraocular pressure by at least 30% (or 18 mm Hg);
• Preparations of the second choice.The main characteristic is a decrease in IOP by 20%. Medicines from this group are used for intolerance of first-choice drugs or their inefficiency;
• Combined funds.It is necessary in the absence of effectiveness from the use of drugs from the first two groups. Sometimes combined therapy is a combination of drugs from groups of drugs of the first and second choice.

The main condition for the selection of the necessary means is the absence of sharp fluctuations in IOP, as a result of which attacks with severe complications may occur. Therefore, sometimes, on the recommendation of a doctor, therapy begins with second-choice drugs.

List

All types of eye drops to reduce the intraocular pressure are divided into several groups, each of which has a certain spectrum of action and active substance.

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Drugs for improving the outflow of intraocular fluid

The main effect of drugs from this group is a sharp narrowing of the pupil, the consequence of which is the pulling of the iris from the iris-corneal angle. As a result, the outflow of intraocular fluid resumes, which leads to a decrease in IOP. The drugs of this group include:

• Holinomimetics:Pilocarpine, Carbocholine. The duration of action of Pilocarpine varies from 4 to 6 hours. Most often, 1 or 2% solutions are used for treatment. The main active ingredient is a vegetable alkaloid. Recent developments have allowed the release of a prolonged-release drug (8-12 h. ), which can be used 1-2 times a day instead of 4-6. Carbocholine (active carbachol) has a therapeutic effect after 20-30 minutes. The maximum reaches in 2 hours. and lasts for 6-8 hours. ;
• Prostaglandins:Xalatin, Travatan, Lumigan. The action of prostaglandins is based on the relaxation of the intraocular muscles, which leads to an increase in the outflow of intraocular fluid. Preparations of this group are most preferable for treatment, since their use is limited to only once a day;
• Sympathomimetics:Adrenaline, Epinephrine, Dipivefrin, Combigan. Preparations of this group are used only 1-2 times a day, but they have a number of side effects systemic and local nature: tachycardia, cardialgia, increased blood pressure, redness and burning in conjunctiva. The easiest to tolerate is Dipiwefrin, which is used in the treatment of the elderly and having cardiovascular damage to patients.

Drugs to reduce the production of watery moisture

The second area of ​​influence on IOP is the use of drugs that reduce the production of aqueous humor. All these drugs are also divided into several groups:

• Inhibitors of carbonic anhydrase: Azopt, Trusopt. The action of drugs inhibits the production of carbonic anhydrase, an enzyme involved in the production of intraocular fluid. Thus, the IOP decreases;
• Agonists of alpha 2-adrenergic receptors: Brimonidine, Alfagan, Iopidine. The active substances of the preparations selectively stimulate alpha 2-adrenergic receptors without exerting systemic effects and thereby reducing the production of intraocular moisture;
• β-blockers: Timolol, Proxodol. Inhibiting the secretion of intraocular fluid, drugs with prolonged use can also improve its outflow. At the same time, the IOP decreased by 35% from the initial indices. The popularity of using these funds is also based on the possibility of applying only once a day.

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Combined preparations

Sometimes the difficulty in using drugs causes the need to use several drugs at once. In this case, the optimal solution is the prescription of the drug from the combination group. This helps to reduce the risk of confusing drugs, since most patients are elderly people. And in some cases, even allows you to reduce the number of treatment procedures.

A group with such properties includes preparations:

• Xalacom.Combines the action of latanoprost (analogue of prostaglandin) with timolol (β-adrenoblocker);
• Kosopt. Combined action is provided by active substances: dorzolamide hydrochloride (inhibitor of carbonic anhydrase) and timolol;
• Fotil.Contains two active components: pilocarpine (holinomimetic) and timolol.

Each drug has a certain number of contraindications and side effects (sometimes - a pronounced systemic nature). Therefore, the selection and use of these drugs should only take place under the supervision of an ophthalmologist. Any change in the effects of the use of drugs should be an occasion for further consultation of a physician.

Recommendations for use

During treatment, it is necessary to follow several rules for the use of eye drops to maximize the therapeutic effect:

• To keep clean.Be sure to wash your hands before the instillation procedure. Do not touch the tip of the eye dropper. Use only your medications and do not give your medication to someone else's hands;
• Find the "pocket".That the medicine has not emerged at instillation, it is necessary to accept a convenient pose and to pull back a lower eyelid (it is better before a mirror). When the drug gets into the "pocket you should gently close your eyes and stand for at least 2 minutes;
• To achieve the desired effect.To prevent leakage of the medicine from the eye, it is necessary not only to close the eyes, but also to press lightly on the inner corner, since the drops can flow down the nasolacrimal canal into the nose;
• Time of instillation. The procedure should be the same at intervals: when instilled twice - 12 hours, three times - 8 hours, and so on. If it is necessary to drip 2 or more drops, then the interval between their introduction should be at least 3 minutes. (ideally - 5). When used in the treatment of ophthalmic ointment, it is used last, and the interval between the use of drugs during one procedure should be at least 20 minutes. ;
• Soothe your eyes. To avoid the irritating effect that many eye drops possess, it is recommended to take preliminary (for 5 min. ) to drip into the eyes a soothing drug such as "artificial tear".

The main rule - do not neglect the recommendations of the ophthalmologist, even seemingly insignificant. This will help to avoid a lot of unpleasant phenomena in the treatment of eye drops.

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conclusions

Eye drops from glaucoma and eye pressure to date are represented by a number of effective drugs with the most varied direction and therapeutic effect.

Therefore, the selection of the necessary medicinal product can be performed only with the participation of a qualified specialist after a comprehensive examination. A prerequisite for successful treatment is also constant monitoring of IOP and regular consultations with an ophthalmologist.

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