Understanding the intricate relationship between certain medications and glaucoma is essential for individuals with this eye condition. Various drugs can impact the development and management of both open-angle and angle-closure glaucoma, emphasizing the importance of consulting your eye doctor before making any changes to your medication regimen. Learn more about which drugs pose the greatest risk for developing or worsening different glaucoma types.*

Narrow-angle and angle-closure glaucoma

Angle-closure glaucoma (ACG), a significant eye condition caused by a too-narrow drainage angle in the eye, can lead to optic nerve damage if not treated promptly. It manifests in two forms: chronic and acute. The chronic type progresses slowly and may not present symptoms until significant vision loss occurs, requiring treatment with medication, laser therapy, and/or surgery. 

In contrast, acute angle-closure glaucoma demands immediate medical attention, due to its rapid onset and severe symptoms, including eye pain, nausea, and blurred vision. Quick intervention with eye pressure-lowering medications and laser iridotomy is essential to prevent blindness.

Medication-induced risk factors

Certain drugs heighten the risk of developing medication-induced angle-closure glaucoma, especially in individuals with preexisting narrow angles or specific demographic traits such as:

• Older age 
• Female sex 
• Hyperopia (farsightedness)
• Asian descent
• A family history of glaucoma 

Anticholinergics, commonly used to treat various conditions, can adversely affect those with narrow angles. These drugs include medications used to treat:

• Allergies
• Anxiety and depression
• Asthma and COPD 
• Incontinence  
• Gastrointestinal issues 
• Muscle spasms 
• Nausea  

Additionally, drugs containing ephedrine or sulfonamides and oral steroids can trigger acute angle-closure attacks or exacerbate open-angle glaucoma by increasing eye pressure.

Open-angle glaucoma and medications

Primary open-angle glaucoma (POAG), the most prevalent form, progresses slowly and often remains asymptomatic until advanced stages. Depending on the severity of your existing optic nerve damage and vision loss, managing this condition usually involves one or more of the following:

• Medications to manage underlying conditions like high blood pressure
• Medicated topical eye drops
• Laser therapy 
• Incisional surgery

POAG can also be impacted by medications used to treat unrelated conditions. Oral steroids, which are used to treat a range of autoimmune and inflammatory diseases, as well as allergies and asthma, can affect eye pressure. Patients with open-angle glaucoma are advised to discuss the use of oral steroids with their ophthalmologist to monitor potential risks closely.

If you have glaucoma, consult your healthcare providers before altering your medication regimen, particularly if you have a history of narrow-angle or angle-closure glaucoma. This ensures that the benefits of any given prescribed medication can be carefully weighed against the potential risks of exacerbating your glaucoma symptoms or accelerating nerve damage and vision loss. 

*Ou, Y. (2023, January 9). Medications That May Adversely Affect Glaucoma. BrightFocus Foundation. https://www.brightfocus.org/glaucoma/article/medications-may-adversely-affect-glaucoma 

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