Is it necessary to use four eye drops to control eye pressure?

Question

Hi doctor,

Four eye drops are used in combination to control eye pressure in case of glaucoma. They are Dorzolamide, Timolol, Brimonidine and Xalatan. In what sequence with how much gap should they be given to control eye pressure? Also for controlling afternoon pressure, either Dorzolamide or Brimonidine, which is better? Should I give Dorzolamide three times or Brimonidine three times?

Answer 1

Hello,

Welcome to icliniq.com.

It is necessary to use more than one drop when intraocular pressure is not controlled by a single drug. Every drug you mentioned has a different mechanism of action. It is good till IOP is controlled with medical management. Each drug is having different mechanism and one drug does not interact or interfere with others mode of action or effect. Time of day for better efficacy is not proved for all drugs. It is good to use Xalatan (Latanoprost) at night before sleep. The rest of them you have to use two times a day. You can use Timolol first, followed by Brimonidine with a gap of at least 10 minutes. Then, followed by Dorzolamide again with a gap of 10 minutes. Do not use them three times. Use Dorzolamide and Brinzolamide only two times. For evening pressure, do eye massage or rubbing with palm light-handedly after washing with clean water. Other medicines have to be followed as such.