Advice on how to choose the most effective drops from glaucoma
In glaucoma, one of the most important and necessary methods of conservative treatment are eye drops from glaucoma, which help to reduce and control intraocular pressure. A chronic increase in pressure may eventually lead to optic atrophy and complete blindness.
How are eye drops used?
The main substance, which is the analog of the cable and transmits the image from the retina of the eye to the brain, is the optic nerve. This part of the optic nerve is called the disc, and its atrophy occurs gradually to the center from the periphery. Clinically, this is manifested by the fact that a person ceases to see "the corner of his eye" or narrowing his peripheral vision, becoming narrow or "tunnel".The next stage after this is complete blindness.
The amount of nerve fibers in the optic nerve is approximately 1000, and with each increase in intraocular pressure some part of them is killed. Therefore, treatment with drops that significantly reduce the pressure in the eye and are used in the initial stages of the disease should be carried out strictly by the hour.
Before you can treat glaucoma, you need to know that delaying or forgetting patients can lead to a deterioration in the condition and loss of optic nerve fibers. The use of drops strictly according to the instructions with preventive examination and measurement of IOP can preserve vision for many years.
Types of antiglaucomatous drops
The main task of drops is to decrease the intraocular pressure, which can be achieved in various ways. By the mechanism of action and hypotensive effect, all drops from glaucoma are divided into 3 groups:
- Drops that can reduce intraocular pressure by improving blood flow and outflow of aqueous humor from the eyeball. This group of drugs is also called miotic and is divided into several groups of drugs with different pharmacological effects.
- Means that can reduce pressure by reducing the production of aqueous humor. Normally, the ciliary body cilia correspond to this function, and the products that are part of this group of drugs are also of several kinds.
- Combined action drugs are drugs that reduce the production of aqueous humor and improve the outflow of intraocular fluid at the same time. These include agents such as fotil( fotil forte), which is a combination of timolol and pilocarpine, as well as proksofilin, Kosopt and xalak. The effect of these drugs lasts at least 12 hours( up to 24 hours).
Eye drops that improve the outflow of intraocular fluid are divided into the following pharmacological groups:
- Cholinomimetics - in this group there are substances of vegetable( pilocarpine) and synthetic origin( carbohydrate).Their main property is the narrowing of the pupil, due to which the iris is drawn from the iridescent-corneal membrane. As a consequence, the intraocular fluid begins to flow away and the pressure decreases. These drugs are helpful in the closed-angle form of glaucoma. The side effect is manifested in narrowing of the pupil and decrease in the clarity of vision. In addition, with prolonged admission, conjunctivitis or dermatitis may occur. The main drawback is the short-term effect of this group of drugs( up to 6 hours).
- Sympathomimetics - this group of drugs includes epinephrine( epinephrine), which simultaneously affects the nervous system. Side effects include symptoms such as reddening of the mucous membrane, mydriasis( dilated) pupil, increased blood pressure and violation of the heart rhythm.
- Prostaglandins - this group of drugs include travatane and xalatan, which last for 24 hours. Widely used for open-angle glaucoma. Side effects include redness of the mucosa, puffiness, burning sensation in the eyes.
Eye drops for glaucoma, which reduce the production of aqueous humor, are also divided into several groups:
- Carboangidrase inhibitors - this group includes substances such as azotite and trusopt, which block the ciliary body enzymes and the enzyme carbonic anhydrase.
- α 2-adrenoreceptor agonists - these include clonidine( clonidine) and brimonidine. A distinctive property of these substances is a double action - improve the outflow and reduce the production of moisture.
- β-adrenoblockers - to substances of this group include timolol( other names are arutimol, ocupress, okumed) and proxodol. These drops can not be taken to people with obstructive lung diseases, corneal dystrophy, a violation of the rhythm of cardiac activity.
It is not recommended for patients with glaucoma to prescribe drugs themselves, even if they are widely advertised in the media. All eye drops from glaucoma should be prescribed by an ophthalmologist.