Systemic glaucoma treatment

Carbonic anhydrase inhibitors

Acetozolamide

Dose: To be used up to 4 tablets per day.

Side effects: Use of oral acetazolamide is associated with tingling, numbness, altered taste, indigestion, nausea, vomiting, skin rashes. Take food rich in potassium (orange juice, bananas, coconut water) to reduce side effects. In some cases, potassium supplement tablets may be prescribed.

Contra-indicated: Not to be used in patients with sickle cell disease (particularly for oral medication). Not to be used/or used with caution in patients with poor renal function, or history of renal lithiasis (renal calculi) or gallbladder lithiasis (gallstones).   As patients with sulfa allergy may get allergy from carbonic anhydrase inhibitors, please discuss this with your ophthalmologist.


Hyperosmotic agents

Mannitol

Dose: usually to be a one time use for acute angle closure attack and other specific conditions for in hospital use.

Side effect: Use intravenous mannitol may pull water from the tissues into the vessels, and may cause many systemic side effects, such as dehydration headache, nausea, diarrhea, vomiting, dry mouth, thirst, blurred vision, vomiting, runny nose, arm pain, chills, dizziness, low blood pressure (hypotension), hives, irregular heart beat, electrolyte imbalance, etc.

Contra-indicated: Not to be used in patients with poor renal function, or poor cardiac function (congestive heart failure), and other specific systemic conditions.

Glycerol: also may be used for acute angle closure. Glycerol is an oral solution, and as mannitol, may also cause many systemic side effects. Particularly, this medication should be avoided by patients with Diabetes.


World Glaucoma Association

Important message for glaucoma patients

It is important for you to get yourself regularly screened for glaucoma. If you have been diagnosed to have glaucoma, effective treatment options are now available and regular treatment and follow up can help you to preserve your vision for your lifetime, avoiding unnecessary fear of going blind.

You can live happily with glaucoma and enjoy an excellent quality of life, particularly if the disease is detected early and treated in time. Always remember that once you have glaucoma, you will have to be under the care of an eye doctor for the rest of your life.

There is a lot of research going on and new treatments may become available for glaucoma in the near future.

World Glaucoma Association