I’m Allergic to My Glaucoma Eye Drops. Is This Common?

It’s common for glaucoma patients to use prescription eye drops regularly. Many patients will use eye drops for years without any issues. While it’s uncommon for people to have an allergic reaction to eye drops, it can happen.

If you’re experiencing issues with your glaucoma eye drops, it’s essential to talk with your doctor right away so that they can make sure you are taking the safest and most effective treatment for your condition.

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Always Follow the Doctor’s Instructions

You must use your glaucoma eye drops as prescribed by your ophthalmologist. That includes taking every dose, every day. Not following instructions can cause you to lose your vision.

It’s also vital to tell other doctors which glaucoma medications you take. Mixing medications can potentially cause them to counteract or cause side effects.

Added Preservatives Are the Likely Culprits of Allergic Reactions

Few people are allergic to their actual medication. It is far more common to be allergic to the preservative added to the medication. Some people are sensitive to preservatives and may have an allergic reaction when using glaucoma drops.

The following preservatives are some of the more common allergens:

• Benzalkonium chloride
• Chlorobutanol
• Phenylethyl alcohol

Some medications, including Timoptic XE, Alphagan P, and Travatan Z, use a different preservative. For example, Alphagan P uses Purite, a Stabilized Oxychloro Complex (SOC) preservative, and Travatan Z uses SofZia, a robust ionic buffered preservative that is gentle to the ocular surface.

Allergies to actual medication may also occur. Whether you are allergic to the drug or the preservative, switching to another glaucoma medication may be the only way to avoid intolerable discomfort. Working with your eye doctor to find a medication you can take safely with minimal reaction may take some time and effort but is usually worthwhile in the long run.

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Your ophthalmologist may prescribe more than one of the following glaucoma eyedrop medicines:

Alpha Agonists for Glaucoma

Alpha agonists work by reducing the amount of fluid your eye produces. They also increase the amount of fluid that drains from the eyes to lower eye pressure.

Possible side effects of alpha agonists include:

• Red, stinging, or painful eyes after using drops
• Blurry vision
• Allergic reaction (redness, itching, tearing, and swelling of the eye)
• A large (dilated) pupil
• Headaches
• Dry mouth
• Feeling tired, weak, or dizzy
• An increase in blood pressure
• A fast or irregular heartbeat
• Feeling nervous

Beta-Blockers for Glaucoma

Beta-blockers also reduce the amount of fluid produced by your eyes to help lower pressure.

Possible side effects of beta-blockers include:

• Red, stinging, or painful eyes after using drops
• Blurry vision
• Breathing problems in people with asthma, emphysema, or COPD
• A slow or irregular heartbeat
• Feeling tired
• Depression
• Dizziness
• A change in sex drive or sexual function
• Getting overly tired during exercise
• Low blood sugar symptoms in people with diabetes that becomes difficult to notice

Carbonic Anhydrase Inhibitors for Glaucoma

Your ophthalmologist may have you take this medicine as an eye drop or by mouth as a pill.

Possible side effects of carbonic anhydrase inhibitors include:

• Stinging eyes after putting drops in
• Red eyes
• Blurry vision
• A skin rash (especially in people who are allergic to sulfa drugs)
• Changes in how things taste to you (especially with carbonated drinks)
• A bad taste or upset stomach (nausea)
• Feeling tired
• Decreased energy
• Increase in urination (with the pills)
• Tingling around the mouth and fingertips (with the pills)

Miotics for Glaucoma

Miotics make your pupil constrict (get smaller), increasing the amount of fluid that drains out of the eye.

Possible side effects of miotics include:

• Blurry vision
• Nearsightedness (trouble focusing on distant objects)
• Dim vision with difficulty seeing in the dark or at night
• Headache or brow ache (aching around the eye)

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While very rare, your retina could detach. A detached retina happens when the light-sensitive tissue lining the back of the eye pulls away. As a result, you would notice dark specks, spots (floaters), or flashing lights in your vision. If you have these symptoms, call your ophthalmologist immediately.

Prostaglandin Analogs for Glaucoma

Prostaglandin analogs work by increasing the drainage of fluid out of your eye.

Possible side effects of prostaglandin analogs include:

• Red, stinging, or painful eyes after using drops
• Feeling like something is in your eye
• Blurry vision
• A permanent change in your eye color (occurs mainly in hazel eyes)
• An increase in thickness, number, and length of eyelashes
• Darkening of the eyelid
• Upper respiratory tract infections, such as colds and flu
• Joint aches
• Light sensitivity
• Eyes that gradually sink deeper into their sockets, keeping eyelids from working properly

Blurry vision, stinging, and redness may improve with time. But if the side effects still bother you, call your ophthalmologist. They may be able to lower your dose or change your medicine. Most side effects go away when the medication is stopped. Never suddenly quit taking your medicine unless instructed by your doctor.

Preservative-Free Eye Drops and Other Medications Are Available

Some pharmaceutical companies also produce their eyedrops in small doses that are preservative-free. However, they need to be refrigerated and usually cost more than the standard eye drops. Your local pharmacy can usually order them for you. If your doctor has prescribed glaucoma medication for you and you are having a reaction, discuss it with them as soon as possible so they can change your treatment plan or prescribe an alternative medication.

In February 2012, ZIOPTAN™ (tafluprost ophthalmic solution) 0.0015% was approved by the FDA as the first preservative-free prostaglandin analog glaucoma medication.

In addition, preservative-free timolol and dorzolamide/timolol glaucoma medications are available.

Help Us Find a Cure

While there’s no cure for glaucoma, advancements in glaucoma research continue to bring us closer to finding a cure and restoring vision loss from glaucoma. You can help find a cure with cash, stock, or a vehicle or boat donation. Your support will give hope to those living with glaucoma and accelerate our search for a cure and vision restoration.

Posted on June 17, 2022

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