Table 3.

Summary of drugs used to treat glaucoma

Drug class	Mechanism	Clinical use	Ocular side effects	Systemic side effects
Prostaglandin analogues –Latanoprost –Travoprost –Bimatoprost –Tafluprost	Increase aqueous humor outflow	Preferred first-line therapy (lowering of IOP by 6–7 mm Hg) Superior lowering of IOP; proof of neuroprotection pending	Blurred vision Lid changes Dry eyes Heterochromia Hypertrichosis Hyperemia	Uncommon
β-blockers –Timolol –Betaxolol –Levobunolol	Decrease aqueous humor production	Acceptable first line therapy (lowering of IOP by 5–6 mm Hg) Proof of neuroprotection (Epstein et al. 1989)	Burning/stinging	Broncho-spasm Worsening heart failure Bradycardia Heart block Depression
α-agonists –Brimonidine	Increase aqueous humor outflow, decrease aqueous humor production	Appropriate first-line therapy (lowering of IOP by 3–4 mm Hg) Proof of neuroprotection (LoPGTS)	Hyperemia Allergic conjunctivitis	Somnolence (more common in children)
Carbonic anhydrase inhibitors –Dorzolamide –Brinzolamide	Decrease aqueous humor production	Appropriate first line therapy (lowering of IOP by 3–4 mm Hg) No proof of neuroprotection (EGPS 2005)	Burning Hyperemia Allergic conjunctivitis	Allergic reaction Angioedema (rare)