Types of glaucoma eye drops

Most people with glaucoma are treated with eye drops. There are several types of eye drops for glaucoma but all of them reduce the pressure in your eye. Used regularly as prescribed, they help keep the pressure at the right level for you, which reduces the risk of loss of vision. If you need help on using eye drops for glaucoma, or to see the eye drop aids that can help, click on the links. Our leaflet Eye Drops and Dispensing Aids can be ordered free of charge and our helpline is always happy to help as well. 

All types of glacuoma eye drops may cause mild irritation. However, you should continue to use the eye drops and report any problems you have to the eye specialist at your next clinic visit. If you cannot tolerate the irritation, you should arrange to see your GP or eye specialist as soon as possible.

Some eye drops may cause an allergy. If the eyes become red and puffy, stop the drops and go and see your GP or eye doctor as soon as possible. If the eye drops are making you feel unwell or breathless, stop the drops immediately and consult your GP as soon as possible.

The name on the bottle (generic and branded products)

There are various types of pressure-lowering eye drops used in the treatment of glaucoma. All the drugs used in them have standard pharmaceutical names, which are not trademarks. If your drops are only labelled with the names of the drug or drugs they contain, they are said to be ‘generic’. However, many drops are better known by their trade name, invented by the company that developed the drug and took out a patent. Call our helpline: 01233 64 81 70 or email sightline@iga.org.uk if you have questions about your eye drops.

What’s the difference between generic and branded products?

The active ingredient(s) are the same and at the same concentration. Other constituents may vary very slightly but the eye drops are essentially similar. The bottle and packaging are likely to be different, and might vary from one prescription to another.

Most people have no trouble with generic drops, but there can be some issues. For example, the design of the bottle might not fit your compliance aid or you may not be able to squeeze the new bottle if the plastic is too hard. Very rarely the slightly different formulation may not suit you. If you experience any difficulty you should discuss it with your eye specialist, GP or pharmacist. Alternatively, our Sightline operators may be able to help and advise.

Combination drops

If you need two different types of medication, using a combination drop can have advantages over using two drops separately. It saves both time and having to keep two different bottles. It also means that you deliver less preservative to the eye, which may reduce the possibility of developing an allergic reaction to the preservatives. However, with the exception of one eye drop, all contain timolol, which may not be suitable for some patients because of possible side effects.

Different categories of drops

The drugs used in eye drops to treat glaucoma fall into various categories, according to the way in which they work.

Alpha agonists (apraclondine and brimonidine)

The action is to reduce the production of fluid in the eye and to improve the flow of fluid out of the eye. They are usually used two or three times a day. Brimonidine is licensed for the long-term treatment of glaucoma but apraclonidine is for short-term use following, or to delay, laser treatment. Brimonidine is contra-indicated for children under the age of two years. Possible side effects include a dry mouth, tiredness and general weakness.

Occasionally a few people may develop a severe allergic reaction to these drops. If this happens, the eye becomes increasingly red, sore and sticky. Sometimes it can take several months for this to happen. If it does develop, you should consult your ophthalmologist or GP without delay.

Beta blockers (betaxolol, carteolol, levobunolol and timolol)

The action of these drops is to reduce the production of fluid in the eye. They are used once in the morning or twice a day, as advised by your ophthalmologist. They are not usually prescribed for anyone susceptible to chest or breathing problems. Possible side-effects include a slow pulse, dizziness, asthma and tiredness. In some people these drops may cause depression, loss of libido or impotence. However, most people have no problems with them.

Carbonic anhydrase inhibitors (brinzolamide and dorzolamide)

The action of these drugs is to reduce production of fluid in the eye. These drops are used two or three times a day on their own, or twice a day if with another drop.

Possible side-effects include redness of the eye, crusty eyelashes, fatigue and a bitter taste in the mouth.

Cholinergic agonist (pilocapine)

The action is to improve the flow of fluid out of the eye through its usual route and the drops are used three or four times a day.

Prostaglandin/prostamide analogues (bimatoprost, latanoprost, tafluprost and travoprost)

The action is to improve the flow of fluid out of the eye through a different way from the usual one. The drops are used once a day, usually at night. Possible side effects include a pink eye that usually improves over a period of time. The iris may darken in colour (more commonly in those with green or hazel eyes and less commonly in blue eyes). Eyelashes may grow longer and darker and, in a small percentage of patients, the skin around the orbit of the eye may darken.