Glaucoma Medication Therapy: Current Concepts and New Developments

Topical glaucoma medications are commonly used to lower intraocular pressure (IOP) which is the only effective treatment to preserve visual function in glaucoma patients. Now we are lucky to have many classes of medication in hand, but sometimes physicians are confused about what medication(s) to initiate with, what's the rationale behind the choice, and to what level IOP should be reduced. Besides, some glaucoma patients are susceptible to the nocturnal fluctuation of IOP, and not all medications work as well at sleep time, and treatment in pregnant women and breastfeeding mothers has special concerns.

Topical glaucoma medication launched after 2014 will be reviewed concisely in terms of mechanisms of IOP-lowering, dosing regimen, efficacy, safety profile, and contraindications. Many of them decrease IOP by enhancing the trabecular outflow, allowing ophthalmologists to combine drugs with complementary IOP-lowering mechanisms to achieve a further meaningful reduction in IOP.