The second major cause of vision loss sensitivity is known as glaucoma. This occurs usually when the nerve connecting the eye to the brain is damaged due to high eye pressure. This disease is more prevalent with advanced age and affects both men and women equally. About 90% of glaucoma cases are known as Open angle glaucoma (OAG). It is the most common type; it’s usually more common in people with a family history of the disease. This disease is rare in those below the age of 40 however those above the age of 60 have 7 times the risk. Another form of this disease is called Angle closure glaucoma (ACG), which is very rare because it is mainly common in those of Asian decent. It also mainly affects those above the age of 40 with equal risk for all patients above the age of 50. The third type of glaucoma is known as congenital glaucoma, which mainly targets 50% of childhood glaucoma and is more common in boys. Glaucoma is predominant in African Americans than whites. It boons at a earlier age with greater intraocular pressures (IOP). That is the main cause of irreversible blindness because it is so difficult to control. Primary Glaucoma is irrelevant to another condition or secondary when it results from another ocular or systemic disease. The glaucoma’s can also be identified on the basis of anatomy of the anterior chamber angle of the eye, either as open-angle glaucoma (OAG) or angle closure glaucoma (ACG). Congenital glaucoma occurs in childhood and characterized by increased IOP and visual impairment. Many people with glaucoma usually don’t have any symptoms, the first sign would be them experiencing loss of vision which can go undetected until later in the disease. Therefore, giving glaucoma the name “sneak thief of vision.”
It is highly recommended to get your eyes examined every 1-2 years in order to detect glaucoma. Glaucoma could be treated in a variety of ways, some which may include prescription eye drops, laser surgery or microsurgery. The main goal of treatment is to lower the intraocular pressure as quickly as possible to prevent further damage to the optic nerve head. When it comes to drug therapy of glaucoma it’s recommended to use cholinergic, carbonic anhydrase inhibitors, diuretics, adrenergic, and prostaglandins. Each of these drugs is unique in their own way. Cholinergics lower the IOP in angle closure glaucoma and open angle glaucoma by decreasing aqueous outflow. Carbonic anhydrase inhibitors are also used in open angle glaucoma and angle closure glaucoma by lowering the aqueous production by 50%. Diuretics are recommended for acute angle closure glaucoma to move the water from the extravascular to intravascular compartment, which results in also decreasing aqueous production. Prostaglandins are used in open angle glaucoma to increase aqueous outflow, they’re also sometimes used as the primary drug treatment. The assigned drug Tafluprost goes in the prostaglandin category.
Tafluprost is used in reducing intraocular pressure in patients with open angle glaucoma. Increasing the outflow of aqueous humor via the uveoscleral pathway lowers the IOP. The exact mechanism on how it lowers IOP is unknown. This drug has a maximum reduction of IOP for 12 hours; it is absorbed through the cornea and takes about 10 minutes to reach its peak. The drug itself (Tafluprost) is hydrolyzed to Tafluprost acid, and then further metabolized via fatty acid beta-oxidation and phase II conjugation. The usual dose is one drop in affected area (eye) once daily in the evening. It’s not recommended to exceed the daily dose because it’s shown that more frequent dosing could lower the IOP lowering affect. Some concerns include increasing the brown pigmentation of the iris, eyelids and eyelashes. The pigmentation of the iris could be permanent even though the change may not be noticeable for years. However the pigmentation of the eyelids and eyelashes may be reversible after the discontinuation of the therapy. In cases with pediatric patients, there is a possibility of increasing pigmentation in long term use which is a safety issue so its not recommended. Nonsteroidal Anti-Inflammatory Agents can diminish the therapeutic effect of Prostaglandins. However, they can also enhance the therapeutic effects of Prostaglandins.