High intraocular pressure not only increases the risk of developing glaucoma, but also makes the progression of glaucoma and visual field defects. The cornerstone of the glaucoma treatment is to reduce intraocular pressure, or with drops or surgery. The progression of visual field defects may be suspended if near the eye pressure is reduced below 12 mm Hg, even patients with a type of glaucoma which are visual field defects and progress, despite pressure from the eye to the normal range (normal voltage glaucoma), IOP decreased by 30% is associated with a lower loss of vision.
Other strategies for independent eye pressure in glaucoma treatment are under study. These include increased blood flow to the optic nerve and offers a number of forms of neuroprotection. Maybe in the future are also other ways of intraocular pressure in glaucoma management to reduce. Until then, the reduction of intraocular pressure is the only way to reduce the risk of glaucoma visual field loss and remains the primary goal of treatment.
There are two important mechanisms for intra-ocular pressure: a) Reduce the amount of aqueous in the eye of reducing the production of aqueous, and 2) Increase the amount of the aqueous humor of eye, namely the omission of the largest Part of the aqueous humor. Some drugs reduce the production of aqueous humor, while others raise the outflow. The aqueous humor leaves the eye by two routes: one that is sensitive to the pressure of the eye (trabecular way) and that operates independently of the pressure in the eye (the way uveoscleral).
Of all the options available, a reasonable first approximation would be a drop in the eye causing intraocular pressure as low as possible to secure every patient to choose. The choice of the first agent is guided by patient characteristics and medical conditions. The driver is to avoid known problems with side effects while maintaining the convenience of a once-daily dosing to maximize compliance. The first drop in the eye may be Timoptic, Xalatan or Alphagan. Each patient must be checked regularly to ensure that the IOP was maintained at a level low enough to prevent the progression of glaucoma. If the intraocular pressure, a further reduction is needed, it is better to add a drop in the eye with a different mechanism of action as the original drug. For example, if the original eye drop Xalatan is used for work by increasing uveoscleral production, then the second bottle of Trusopt Timoptic drops at work by reducing production of aqueous humor. We discuss the key points to consider medication. We have used, because the brand is well known by names, but several drugs are available at the same efficiency and cost-effective generic form.