Potency of glaucoma drops

Key points

• The goal of topical therapies is to preserve visual function by lowering intraocular pressure (IOP) below a level that is likely to produce further damage to the optic nerve.
• The growth in available agents for the medical treatment of glaucoma has increased dramatically over the years.
• It is important to note that no individual medication can be used in all patients in all circumstances.  The goals of therapy are preserving function with the lowest risk, fewest adverse or undesirable effects, and least disruption of the patient's life.
• An initial reduction in the intraocular pressure of 20% from baseline is suggested.
•  Patients with more advanced disease on initial presentation require lower initial reductions to prevent further progression and vision loss.
• The reduction of IOP to the target pressure range does not guarantee that progression will not occur. Therefore, the target pressure range needs to be constantly reassessed and changed as dictated by IOP fluctuations, optic nerve changes, and/or visual field progression.
• Generic versions of these topical products do not have to prove bioequivalence or equal effectiveness. Data is generally not available for guidance on selection.
• Topically administered glaucoma medications can have significant systemic absorption.  Patients must be instructed on the proper administration techniques to reduce the risk of systemic adverse effects.