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# Antiglaucoma agents

Eye drops that lower intraocular pressure to protect the optic nerve: prostaglandin analogues, beta-blockers, alpha-2 agonists and others.

Updated Nov 1, 2026

## What they are

Drugs that lower intraocular pressure in open-angle glaucoma and ocular hypertension. Each group acts on a different step of aqueous humour: making less of it or draining more of it.

## Mechanism of action

Prostaglandin analogues (latanoprost) increase uveoscleral outflow. Beta-blockers (timolol) and carbonic anhydrase inhibitors (dorzolamide) reduce aqueous production by the ciliary body. Alpha-2 agonists (brimonidine) do both. Cholinergic miotics (pilocarpine) open the trabecular meshwork by contracting the ciliary muscle.

Target: Aqueous humour production (ciliary body) and outflow (uveoscleral and trabecular)

## Key points

- Prostaglandin analogues: more outflow; can darken the iris permanently and lengthen lashes.
- Timolol drops are absorbed into the blood: contraindicated in asthma, severe COPD, bradycardia and AV block.
- Brimonidine is contraindicated under 2 years (apnoea, coma).
- Dorzolamide is a sulfonamide with a bitter taste.
- Pressing on the tear duct after a drop reduces systemic absorption.

## Drugs in this class

- [**Latanoprost** A prostaglandin eye drop that lowers eye pressure by helping fluid drain out of the eye. A first-choice drug for… Prostaglandin F2α receptor (FP)](https://durgical.com/en/pharmacology/latanoprost/)
- [**Timolol** A non-selective beta-blocker eye drop that lowers eye pressure. Enough reaches the blood to slow the heart and narrow… β1 and β2 adrenergic receptors](https://durgical.com/en/pharmacology/timolol/)
- [**Brimonidine** An alpha-2 agonist eye drop that lowers eye pressure two ways. It must never be used in babies under 2: it can stop… α2A adrenergic receptor](https://durgical.com/en/pharmacology/brimonidine/)
- [**Dorzolamide** A carbonic anhydrase inhibitor eye drop that lowers eye pressure by making less fluid. A sulfonamide, with a typical… Carbonic anhydrase II](https://durgical.com/en/pharmacology/dorzolamide/)
- [**Bimatoprost** A prostaglandin-like eye drop that lowers eye pressure in glaucoma by draining more fluid. It can darken the iris and… Prostaglandin F (FP) receptor / prostamide receptors of the outflow pathways](https://durgical.com/en/pharmacology/bimatoprost/)
- [**Brinzolamide** A carbonic anhydrase inhibitor eye drop that makes less aqueous humour and so lowers eye pressure. It is a sulfonamide… Carbonic anhydrase II of the ciliary processes](https://durgical.com/en/pharmacology/brinzolamide/)
- [**Betaxolol** A β1-selective beta-blocker eye drop for glaucoma. It affects the airways less than timolol, but can still slow the… β1 adrenergic receptor (cardioselective)](https://durgical.com/en/pharmacology/betaxolol/)
- [**Apraclonidine** An alpha-2 agonist eye drop for short-term extra pressure lowering in glaucoma, for example around laser surgery. Its… α2 adrenergic receptors of the ciliary body](https://durgical.com/en/pharmacology/apraclonidine/)
- [**Netarsudil** A Rho kinase inhibitor eye drop that opens the eye's main drain (trabecular meshwork) to lower pressure in glaucoma… Rho-associated protein kinases (ROCK1 and ROCK2)](https://durgical.com/en/pharmacology/netarsudil/)

## Others in the class

- Bimatoprost, travoprost
- Betaxolol
- Brinzolamide
- Apraclonidine
- Netarsudil

## Test yourself

Think of the answer, then tap the question to see it.

## Which antiglaucoma group increases uveoscleral outflow?

Prostaglandin analogues such as latanoprost.

## Which two groups mainly reduce aqueous humour production?

Beta-blockers (timolol) and carbonic anhydrase inhibitors (dorzolamide).

## Which antiglaucoma drop is dangerous in a patient with asthma?

Timolol, a non-selective beta-blocker.

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Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [DailyMed - LATANOPROST solution/ drops](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=19cdfef0-b770-4758-8f59-1769e4b6119c) (DailyMed (U.S. National Library of Medicine), 2024); [DailyMed - TIMOLOL MALEATE OPHTHALMIC GEL FORMING SOLUTION solution, gel forming / drops](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e93036c6-3120-e989-e053-2a95a90acf7f) (DailyMed (U.S. National Library of Medicine), 2026); [DailyMed - BRIMONIDINE TARTRATE- brimonidine tartrate solution/ drops](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=75c5f708-1afb-4505-94a6-a2c0afb0aedc) (DailyMed (U.S. National Library of Medicine), 2025); [DailyMed - DORZOLAMIDE HYDROCHLORIDE OPHTHALMIC SOLUTION- dorzolamide hydrochloride solution/ drops](https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=4698e4e1-c5f6-4db1-9328-74464a85afea) (DailyMed (U.S. National Library of Medicine), 2026).

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Representative model, for educational purposes only.

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