First prescriptions for glaucoma

This is the latest module in our series supporting pharmacists in their conversations with patients who are receiving a new medicine. The updates cover medications included in the New Medicine Service in England but are relevant to all pharmacists in the UK. 

This module covers topical treatments used in the management of glaucoma and should be read in conjunction with the = clinical update on glaucoma CPD module. 

Key facts

• Topical IOP lowering treatment is the therapeutic mainstay of glaucoma management
• Prostaglandin analogues are generally the first option, but beta-blockers, carbonic anhydrase inhibitors, sympatho-mimetics and miotics also have a place in therapy
• Checking eye drop instillation technique can make a significant difference to treatment outcomes, as can assessing whether the patient would benefit from a compliance aid and then counselling on how to use one
• Side-effects can be a significant hindrance both to adherence and establishing a regular dosing routine. There are techniques that can reduce systemic absorption and hence side-effects, which also increase the amount of time the medication is in contact with the eye
• Lifestyle advice has a part to play in disease management.