Next Generation of Glaucoma Drops

January is Glaucoma Awareness month, so it is a great opportunity to review some of the treatments available. Glaucoma is a group of diseases that affect the optic nerve in the eye. They can cause damage to the optic nerve preventing it from working correctly and can ultimately lead to blindness.   Unfortunately, there are usually no early symptoms and it can go undetected for a long period of time. This is one reason why it is so important to have a regular eye exam. We know that lowering the eye pressure helps prevent damage to the optic nerve is the current goal of our therapy.

Thankfully, with early detection and treatment, most people who have glaucoma remain stable and do not go blind. There have been many advances in the treatment of glaucoma which have given people tremendous benefits. The main treatment form is medical in the form of eye drops. There are many different types of medical eye drops for glaucoma. In this post, we will touch on the two new medications that were introduced in 2018. We will briefly explain how they work on the eye and describe some of their common side effects. We will be referring to these medications by their compound names and avoid using their brand name.

Latanoprostene Bunod Ophthalmic Solution –  This medication was approved by the Food & Drug Administration (FDA) in early 2018. It is an eye drop that is placed in the eye at bedtime. When the drug is put in the eye, it is metabolized or broken down into two separate molecules. Each of these molecules works to lower the eye pressure. The first molecule is latanoprost, which works to increase the eye’s ability to drain out fluid, thus lowering the eye pressure. The other molecule releases nitric oxide, which is a chemical transmitter used to relax tissues around the eye’s natural drainage tube. This is proposed to create a wider opening allowing more fluid to drain out of the eye resulting in lower eye pressure.

It should be noted that one of the metabolized molecules is latanoprost, is a medication that is currently on the market and available in generic form. The novel aspect of this drug is the ability to release the nitric oxide to create additional pressure lowering effect.  The main side effects include burning, redness of the eyes and irritation. There are some unique side effects related to the latanoprost component of the medication including changing the color of the iris, darkening of the skin around the eyes and eyelash growth.

Netarsudil Ophthalmic Solution – This medication was approved by the FDA in mid-2018. It is also used at bedtime. This medication also works to increase the amount of nitric oxide in the eye. It is proposed to work at the cellular level to have certain cells in the eye produce and release nitric oxide which then increases the eye’s ability to drain out more fluid.

There are several side effects that were noted with this medication including redness of the eyes, burning, and irritation. In some patients during their clinical trial, they also noted some small red spots on the skin of the eye and also some small changes on the cornea (the clear part of the eye). These were not noted to have any undue consequences.

Talk to your eye doctor for more information about the potential side effects or any other questions you may have about your glaucoma treatment. As always, at Eye Specialists of Mid Florida, our doctors and staff are committed to providing the highest quality and most technologically advanced eye care in a compassionate, friendly, comfortable atmosphere. Eye Specialists of Mid-Florida’s services include ophthalmology, optometry, cataract surgery, diagnosis and treatment of retinal disorders and glaucoma, eyelid procedures, and refractive procedures, including LASIK.

Written by: Aly R. Sheraly, M.D. 

Dr. Sheraly is a Board Certified Cataract Surgeon, Laser & Cataract Surgeon, Glaucoma Specialist


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