Five Tips About Glaucoma Eye Medications

Managing glaucoma requires a commitment to a daily routine. Because glaucoma is often “silent” (meaning you won't feel your eye pressure rising), the medications are your primary defense against permanent vision loss.

Here are five essential things every patient should know about glaucoma medications:

1. Consistency is Your Most Powerful Tool

Glaucoma eye drops only work for a specific window of time (usually 12 to 24 hours). If you skip a dose, your eye pressure can spike, causing “silent” damage to the optic nerve.

• The Goal: Maintain a steady level of medication in your eye around the clock.
• Pro-Tip: Tie your drop schedule to a daily habit, like brushing your teeth or having your morning coffee, to ensure you never miss a dose.

2. Proper Technique Prevents “Body-Wide” Side Effects

Many patients don't realize that eye drops can enter the bloodstream through the tear ducts, potentially affecting your heart or lungs. You can minimize this using a technique called Punctal Occlusion:

• After putting in a drop, close your eyes gently (do not squeeze or blink rapidly).
• Use your finger to press firmly on the inner corner of your eye (near the bridge of your nose) for 1 to 2 minutes.
• This keeps the medicine in your eye and prevents it from draining into your throat and bloodstream.

3. The “Five-Minute Rule” for Multiple Drops

If your doctor prescribes more than one type of eye drop, wait at least 5 minutes between them.

• Why? Your eye can only hold about one-sixth of a single drop at a time. If you put the second drop in too quickly, it will simply wash out the first one before it has a chance to be absorbed, making your treatment less effective.

4. Side Effects Are Common — and Manageable

Don't be alarmed if your eyes sting, turn red, or feel “gritty” when you first start a new medication.

• Expect Local Changes: Some drops (Prostaglandins) can cause your eyelashes to grow longer or even permanently darken the color of your iris (the colored part of your eye).
• Monitor Systemic Effects: Beta-blocker drops can sometimes slow your heart rate or worsen asthma. Always tell your eye doctor about your full medical history, especially heart or lung conditions.
• Refrigeration Trick: If you have trouble feeling if the drop actually landed in your eye, try keeping the bottle in the fridge. The cold sensation makes it much easier to tell if you’ve “hit the target.”

5. They Don't Make Your Vision Better (But They Keep It)

One of the hardest parts of glaucoma treatment is that the medication doesn't improve your sight or make your eyes feel better — it simply preserves the vision you still have.

• Stay the Course: You may feel like the drops aren't “doing anything” because you don't see a difference, but they are working behind the scenes to prevent blindness.
• Never Stop Suddenly: Abruptly stopping glaucoma medication can cause a dangerous “rebound” spike in eye pressure.

Prosper and be in health

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William Garst is a consultant pharmacist who lives in Alachua, Florida. He is semi-retired and works part time at Lake Butler Hospital in Lake Butler, Florida. William received his pharmacy degree at Auburn University and a Doctor of Pharmacy from Colorado University. The Pharmacy Newsletter is a blog where you can find other informative columns. He may be contacted at garstcph@gmail.com.

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