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    Changing trends that may alter course of glaucoma practices

    Rapid changes in the drug industry are affecting glaucoma practices, said Andrew G. Iwach, MD, who provided an overview of these trends. “It’s an interesting time right now.”

    Among the most important trends in glaucoma medications is the rise of prostaglandins and the decline of other medications to treat glaucoma, said Dr. Iwach, displaying a graph of trend lines from IMS Institute for Healthcare Informatics. Dr. Iwach is an associate clinical professor of ophthalmology at the University of California, San Francisco.

    Watch as Andrew Iwach, MD, outlines how changes in the pharmaceutical industry will affect glaucoma practices.

    Ophthalmologists should take note of adverse reactions, he pointed out. Some patients develop reactions to preservatives. It’s helpful to know that multiple preparations are available, including some that don’t use the preservative benzalkonium chloride (BAK). These include preservative-free preparations of dorzolamide/timolol and tafluprost , though the manufacturers may have changed.

    Dr. Iwach said he treated a patient who developed a reaction to brinzolamide/brimonidine, including an ectropion. Many similar reactions have been reported to brimonidine as well as to dorzolamide.

    “The reason that I bring this up is that if you realize what’s going on, and you stop the medication, and you put a little bit of steroid, maybe cream, it goes away,” he said.

    Generics rising

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