Treatment of glaucoma

There are several treatment options for glaucoma. Topical medications are the most common early treatment for glaucoma because standard practice has been to move on to surgery only if medications are ineffective. 

Eye drops

There are several types of eye drops that doctors prescribe most commonly.

Beta blockers

These reduce the production of aqueous humor and some of the most commonly used are: levobunolol (Betagan ), timolol (Betimol, Timoptic ), carteolol (Ocupress), betaxolol (Betoptic) and metipranolol (OptiPranolol ).

Alpha-adrenergic agents

These medications also reduce the production of aqueous humor. They include: apraclonidine (Iopidine) and brimonidine (Alphagan).

Carbonic anhydrase inhibitors

These medications, which include dorzolamide (Trusopt), reduce the amount of aqueous humor. 

Prostaglandin analogues

These medications are used to increase the outflow of aqueous humor. The most common is latanoprost (Xalatan).

Prostamides

These include bimatoprost (Lumigan). They increase the outflow of aqueous humor.

Miotics

Miotics, such as pilocarpine (Isopto Carpine, Pilocar) increase the outflow of aqueous humor.

Epinephrine compounds

These also increase the outflow of aqueous humor.

Surgery

Trabectomy
During the procedure doctor uses a high-energy laser beam to shrink part of the trabecular meshwork, which causes other parts of the meshwork to stretch and open up. This helps aqueous humor drain more easily from the eye.
 
Conventional surgery
It is called filtering procedure and it is done in a hospital or an outpatient surgery center. Using delicate instruments under an operating microscope, the doctor creates an opening in the sclera and removes a small piece of the trabecular meshwork. The aqueous humor can now leave the eye freely through this hole.