You may notice vision loss and changing glaucoma symptoms if your prescribed medicated eye drops stop working. Your doctor can help test your visual field and determine if you need different drops or adjustments in your treatment plan.

Taking eye drops each day to treat glaucoma means not having a break and having to keep up that routine for the rest of your life.

While a key motivation for people with glaucoma can be to not lose their eyesight and keep the condition from getting worse, there may come a time when those prescribed drops don’t seem to be working as well as they should.

Your eye doctor is the best person to evaluate whether eye drops are still effective and whether your glaucoma is getting worse. They can perform different tests — checking your eye pressure, evaluating optic nerve function, and evaluating your visual field when you look at a series of blinking lights — to help guide your treatment plan.

Learn more about glaucoma and what your health journey may be like with this eye condition.

Once you develop glaucoma, you can’t reverse the damage done to the eye or vision.

When you receive a glaucoma diagnosis, a doctor will typically start you on eye drops. Eye drops are generally the first choice because they can help slow the progression of glaucoma and reduce your intraocular pressure (IOP), a key risk factor for developing and worsening glaucoma.

Here’s how these eye drops work:

  1. Decreasing fluid production: Some glaucoma eye drops work by reducing the production of fluid that fills the front part of the eye. By reducing how much of this fluid is made, eye drops help lower intraocular pressure.
  2. Improving fluid drainage: Some eye drops help improve fluid drainage from the eye. By increasing the outflow of fluid through various drainage pathways, eye drops also help lower pressure.
  3. Combination medications: Some glaucoma eye drops contain a combination of different active ingredients to both reduce fluid production and improve drainage, providing a more effective way to lower intraocular pressure.

While eye drops are definitely the least invasive option, they do require commitment.

Depending on your condition, a doctor may prescribe more than one type of eye drop. You’ll need to use these drops at least once a day for the rest of your life in order to prevent disease progression.

Always make sure not to stop taking your eye drops as prescribed without first consulting your eye doctor, because untreated glaucoma can lead to vision loss.

Types of glaucoma eye drops

There are a several types of eye drops used to treat glaucoma. They may include:

  • Beta-blockers: These medicated eye drops decrease fluid production in your eye. You’d typically use these drops twice daily. This is sold under the name timolol (Timoptic).
  • Prostaglandins: These eye drops increase the amount of fluid your eyes can drain, reducing the level of pressure in your eyes. You’ll typically apply one drop in each eye daily before bedtime.
  • Rho kinase inhibitors: These lower eye pressure by reducing fluid production and improving fluid drainage. Take one drop in your affected eye once daily. May include netarsudil (Rhopressa).
  • Nitric oxide-donating medications, like latanoprostene bunod (Vyzulta), also increase fluid outflow from the eye, decreasing eye pressure. A typical dosage is one drop in each eye every day.
  • Miotic or cholinergic agents: These medications, such as pilocarpine (Salagen), work by constricting the pupil and opening drainage pathways, improving fluid drainage from the eye. Use 1 or 2 drops in your affected eye up to four times a day.
  • Carbonic anhydrase inhibitors: Reduce eye pressure by decreasing the amount of fluid made inside the eye. Taken 1 to 3 times a day. Sold under brand names Azopt (brinzolamide), Diamox (acetazolamide), and Trusopt (dorzolamide).

You may notice or experience some of the following signs or symptoms if your glaucoma eye drops aren’t working the way they should, and if you’ve been taking them as prescribed by your eye doctor.

Your vision may change, with more floaters or patches clouding your vision. This might appear in the following ways:

Share on Pinterest
Design by Maya Chastain

If you believe your glaucoma eye drops are not working effectively, make an appointment as soon as possible with your ophthalmologist or eye care doctor to evaluate your eyes and determine if any changes are needed.

Regular eye exams are important to help your doctor monitor your treatment and glaucoma progression, to make sure that any eye drops you’re prescribed are helping to manage glaucoma and preserve your vision.

Not taking your prescription medications as your doctor recommends can be an issue for treating any medical condition, including eye health and glaucoma.

With glaucoma often not presenting any symptoms and it being a condition that requires a therapy regimen for the rest of your life without improvement, people with glaucoma are more at risk for not taking their treatments as prescribed.

This 2022 research review suggests that possibly 50% of people prescribed glaucoma eye drops aren’t getting the benefit they need from these medicated drops. Reasons for that may include:

  • forgetting to take eye drops (most common reason, according to some research)
  • scheduling when to take the eye drops
  • lack of initial education on how to use the eye drops application techniques
  • not taking them correctly, including closing the eye so the drop doesn’t go in
  • problems with eye drop supply, including cost and access
  • older adults may have difficulty physically giving themselves the eye drops
  • side effects, including lightheadedness and chest pressure

The research review also observed that sight preservation was the main motivation for people taking their glaucoma eye drops as prescribed, and those who continued taking them as prescribed either wanted to maintain their eyesight or were experiencing some vision loss.

In the 2022 study review, the authors noted that several studies found that adherence is “suboptimal” on average for people with glaucoma.

“Ophthalmologists are beginning to discover that nonadherence is more prevalent than previously realized and to understand the burden of glaucoma patients,” the review states, noting that more research is needed to detect what causes this pattern and how eye care professionals can best address it with patients.

Consult your eye doctor

Your healthcare team and eye doctor are the best to discuss concerns you have about glaucoma eye drops and whether they are effectively treating your condition.

They can exam your eyes and order specific tests to determine if your eye pressure is elevated, and help understand how the eye drops are working. They may prescribe other medicated eye drops or offer advise to compliment your current care routine.

If you find that your current eye drops for glaucoma are not effectively managing your condition, it is important to talk with your eye care team about this. They may recommend the following steps:

  1. Review of current treatment: Your eye care provider may reassess your current eye drop regimen, including dosage, frequency, and administration technique, to ensure proper use. They may also review your prescription records and the number of times they have been filled to help determine whether you’ve been taking your eye drops as prescribed.
  2. Switching eye drops: Your provider might recommend changing to a different type of eye drops or combination of eye drops to better control your intraocular pressure.
  3. Additional treatments: In some cases, your doctor may suggest alternative treatments, such as laser therapy or surgery, to better manage your glaucoma. They may also suggest a long-acting sustained-release medication that is implantable, such as Durysta or i-Dose.
  4. Follow-up appointments: Regular eye exams can help you work with your eye care team to monitor the effectiveness of any new treatment plan and make any necessary adjustments.

A key to any glaucoma treatment, including eye drops, is to reduce eye pressure so that glaucoma does not get worse and cause more vision loss. Taking eye drops as prescribed to treat glaucoma is important to prevent this.

An eye care professional can determine if your eye drops are working effectively, or if you might need additional monitoring or adjustments to your treatment plan. They can perform different tests to help evaluate your eye health and determine next steps.