Clinical Medicine Reviews in Therapeutics

Glaucoma is the name given to a group of diseases characterized by incurable, progressive, multifactorial optic neuropathy. It is the second leading cause of blindness worldwide. Ocular hypertension (OH) is the term used to describe the presence of raised intraocular pressure (the most important risk factor for the development of glaucoma) in the absence of demonstrable glaucomatous optic neuropathy.

The management of glaucoma and OH requires a holistic and rational approach, taking into account a number of factors. Treatment needs to be individualized depending on patient age, the severity and type of glaucoma, associated medical conditions, the condition of the ocular surface, tolerability of topical medication, and patient wishes. An understanding of the mechanism of glaucoma and its etiology in a particular patient is crucial for the initiation of appropriate treatment.

This review article summarizes the existing medical management of glaucoma and OH, including pharmacology, mode of action, and safety profile for each major group of medication, and reviews current advances and future developments in treatment for glaucoma, including experimental medications, together with a summary of their modes of action, pharmacology, and safety profiles. It is hoped that readers will become more aware of the evolution of the next generation glaucoma and OH medications.