Eye drops from glaucoma: types of drugs and their characteristics

Glaucoma is a dangerous eye disease. It accounts for the greatest number of all cases of blindness. The insidiousness of the disease lies in the fact that in the early stages the patient does not feel any symptoms. The disease manifests itself only at the stage when the person starts irreversible changes in vision.For the treatment of glaucoma in medicine, drops of different groups are used. In this article, we will talk about antiglaucoma drugs in the form of drops and their features.

Application area

Eye drops from glaucoma are one of the most common treatments for this disease, which, without therapy, can result in total blindness.The only alternative to medications is surgical intervention. However, not all patients are suitable for surgical treatment.

The main cause of glaucoma is increased intraocular pressure.Therefore, the main principle of treatment is the reduction of eye pressure to normal levels. If this is not done, then you can get an incurable blindness because of the loss of the optic nerves.

Normal intraocular pressure is between 18-30 mm Hg. Art.

Eye drops with glaucoma help to lower the pressure and stop the destruction of the optic nerves.

Features of preparations

To reduce the intraocular pressure, it is possible to influence the following eye mechanisms:

• Improve the outflow of intraocular fluid;
• Reduce the production of aqueous humor.

These two principles have become the basis for all drugs used in the treatment of glaucoma.

The peculiarity of the preparations is that after instillation they quickly penetrate to the eye nerves and have a therapeutic effect.Drops from eye pressure gently take care of the eye, protect against redness and dryness. Preparations for glaucoma are released in convenient vials that make the treatment process not only effective, but also comfortable.

If eye drops enter the body, they can cause problems with the gastrointestinal tract and cause dizziness.

Antiglaukomnye drugs in the form of drops in the eyes are represented by three main types (by the mechanism of action):

1. Means, which reduce the production of intraocular fluid(adrenoblockers, inhibitors of carbonic anhydrase). These are such drugs as Timolol, Betoptik, Trusopt.
2. Eye drops improving the outflow of intraocular fluidfrom the eyeball, for example, Pilocarpine, Xalatan, Travatan.
3. Combined drugs with double action.These include Fotil (timolol + pilocarpine) and Proxophilin.

   Fotil - a combined drug used in the treatment of glaucoma

The peculiarity of eye drops from glaucoma is that they accumulate their medicinal properties. This, in turn, allows maintaining the intraocular pressure at a normal level even after the instillation is stopped. Maintaining intraocular pressure within normal limits allows to cure glaucoma and get rid of problems with loss of vision.

The therapeutic effect of the use of medicines is observed from the first day of use.

List

So,the main purpose of eye drops from glaucoma is to lower the level of eye pressure to normal physiological parameters.The drugs selectively affect the system of blood vessels and muscles inside the organ of vision. As a result, they relax, and the symptoms of the disease go away. To this end, the following groups of pharmacological groups are prescribed:

• Holinomimetiki;
• β-adrenoblockers;
• Prostaglandins F2 alpha;
• Selective α-adrenomimetics;
• Inhibitors of carbonic anhydrase.

Next, we will dwell on a detailed description of each of the groups.

Drops of the group of cholinomimetics

The mechanism of action of drugs in this group is to stimulate receptors located in the cells of the walls of blood vessels, which leads to their expansion. List of drugs:

• Pilocarpine 1%(bottles-dropper on, ml). When primary glaucoma should be dripped 1 drop 2 - 6 times a day. With an acute attack of closed-angle glaucoma: during the first 2 hours - 1 drop every 15 minutes; the next 2 hours - every 30 minutes, the next hours - 1 time in 60 minutes. Continue treatment until the decrease in intraocular pressure.
• Carbacholin 3%.It is prescribed for closed-angle glaucoma in the form of installations 2 to 4 times a day. In pharmacies is not available.
• Aceclydine 2, 3, 5% solution.Drip 1 to 2 drops to 6 times a day. Treatment with this drug is possible only in the clinic.

Carbocholine is used only in a hospital.

Pilocarpine is used in the treatment of glaucoma

The action of these drugs develops rapidly. The effect is noticeable after 15 - 20 minutes after application and remains for 4 hours.

These drops narrow the pupil and restore the outflow of the aqueous humor.In addition to the treatment of glaucoma, cholinomimetics are used in ophthalmic practice for diagnostic purposes. Contraindications to the use of cholinomimetics:

• Allergy to one of the preservatives or active components of the drug;
• Inflammation of the choroid, iris or ciliary body;
• Rehabilitation period after surgery.

Side effects:

• Light redness and burning in the eye;
• Painful sensations;
• Short-term reversible vision impairment;
• Headache;
• Lachrymation.

With topical application, a small amount of the active substance of the drug falls into the total bloodstream, so systemic complications (bradycardia, bronchospasm) are rare.

Adrenoreceptor blockers

An alternative mechanism of regulation of intraocular pressure is the effect on specific β - adrenergic receptors. They are not only in the organ of vision, but also in the bronchi, heart, intestines. However, the effect of drops is limited only to the organs of vision. In addition to restoring the normal outflow of aqueous humor, drugs to some extent reduce its production. The list of drugs in this group:

• Pilocarpine 1%Apply 1 drop twice a day. If inefficiency is used,% solution. After the normalization of the pressure, they return to the initial concentration.
• Okumed, 5%10 ml (India).
• Betaxolol,%(Russia). Drip 1 drop twice a day.
• Betoptik, 5%5 ml (USA). One of the best drops from eye pressure.
• Xonef,%5 ml (India).

  Betoptik, 5% used in the treatment of glaucoma

With topical application of the listed drugs, side effects such as photophobia, lacrimation, burning, itching, redness, slight disturbances of visual acuity can be manifested.But these manifestations pass after a while. Very rarely there are systemic complications in the form of slowing down the rhythm of heartbeats, bronchospasm, headache, drowsiness, rhinitis and allergic rash on the skin around the eyes.

Adrenoreceptor blockers are contraindicated for the treatment of glaucoma in children, as well as in chronic vasomotor runny nose, dystrophic processes in the cornea, and heart failure.

Prostaglandins

Drops of this group act on specific receptors located in the muscle of the eyelash. As a result, the work of the drainage system of the eye improves and the normal outflow of watery moisture is restored. The drugs do not affect the size of the pupil, the effect of use persists throughout the day. List of drugs:

• Xalatan, 05%5 ml (USA).
• Glauprost, 05%, ml (Romania).
• Xalatamax, 05%, ml (Croatia).
• Glaumax, 05%, ml (Estonia).
• Travoprost.1 drop once a day.
• Travatan (USA), ml.
• Tafluprost.Disposable bottles. Apply 1 drop in each eye in the evening.
• Taflotan, 015% (30 single-use vials per ml).

  Drops Travan is used in the treatment of glaucoma

With caution, these drops are prescribed for bronchial asthma, lens and iris diseases, keratitis, uveitis, during pregnancy and lactation. Of the side effects noted reddening, burning and itching, pinpoint opacities on the cornea.

Long-term use of these drugs can lead to a discoloration of the eyes.

α-adrenomimetics

The peculiarity of the preparations of this group is oppression of the production of intraocular fluid, which leads to a persistent decrease in pressure within the organ of vision.Currently, only the Brimonidine drug is used from the α-adrenomimetic group. In pharmacies, it is not sold, its use is carried out only in a hospital to treat open-angle glaucoma. Contraindication to prescription medication is the age of up to 2 years, pregnancy and lactation.

Alphagaine is used in the treatment of glaucoma

With care, Brimonidine should be used simultaneously with antidepressants, with diseases of the cardiovascular system.

This medicine does not affect the size of the pupil and does not lead to narrowing of the blood vessels.

Inhibitors of carbonic anhydrase

Drops of this group act on a specific enzyme, which is produced in the ciliary body.The inhibition of its synthesis causes a decrease in the production of intraocular fluid. Only 2 drugs of this group are known:

• Trusopt 2%5 ml (USA);
• Asopt10 mg / ml 5 ml (USA).

  Trusopt is used for the treatment of glaucoma

These drugs are widely used to treat congenital glaucoma and are resolved from the first days of life.However, they are not recommended for use in pregnancy and lactation.

Local adverse reactions occur in only 3% of cases and manifest reddening of the eyelids, dryness, burning. Even less often, headache, nasal bleeding, nausea or vomiting, the formation of kidney stones, weakness, reduced performance. In childhood, these complications are more pronounced.

With care, you should use these drops with a closed angle glaucoma.

Combined preparations

In some cases, the treatment of glaucoma requires the use of complex drugs, which include 2 active components.However, at the same time, the risk of complications increases. Also, the list of contraindications is expanding. List of drugs:

• Fotile5 ml (France);
• Xalacom, ml (USA);
• DuoTrav, ml (USA);
• Kosopt5 ml (USA);
• Dorzopt Plus 5 ml (Romania);
• Eye drops of Azarga5 ml (USA).

  Fotil - a combined drug used in the treatment of glaucoma

Combination drugs are not used in pediatrics.

Decide which drops are better for the treatment of glaucoma and how to use them properly, should an ophthalmologist based on the survey data.

Recommendations for use

Antiglaucoma drugs are used only as prescribed by the doctor.To reduce the systemic effect of the drug, it is necessary to lightly apply pressure on the angle of the eye within 1-2 minutes after instillation. To avoid bacterial infection, you should strictly follow the rules of hygiene.

The method of application and dose of eye drops for glaucoma are selected by the treating ophthalmologist after a complete diagnosis of the disease.

An overdose of drugs for the treatment of glaucoma can occur:

• Because of the long use of drops;
• If the conditions of use are not respected;
• If there are contraindications to the use of medicines.

Symptoms of overdose manifest as local allergic reactions, the development of cardiovascular failure and respiratory disorders.

The interaction of antiglaucomal drops with other drugs is permissible only with the permission of the doctor. Very often a combination of several drugs leads to bradycardia and heart failure.

When using several eye preparations for the treatment of glaucoma, a time interval must be observed in order for each of the drugs to have its medicinal properties.

Video

conclusions

Eye drops against glaucoma are medicines that effectively reduce intraocular pressure, improve the outflow of fluid inside the eye and reduce the production of intraocular moisture. You can use drops only according to the doctor's prescription: many drugs are dispensed only on prescription and require medical advice and supervision. The timely use of drops can cure glaucoma and prevent the flow of the disease into a chronic form.