11.6 Treatment of glaucoma

For general advice on diagnosis and treatment of glaucoma please refer to the NICE Clinical Guideline CG85 (April 2009)

Topical Therapy for Primary Open Angle Glaucoma (POAG)

Glaucoma diagnosed

Treat with a prostaglandin analogue:

  • Latanoprost – first-line
  • Bimatoprost
  • Travoprost

Target Intraocular Pressure (IOP) reached:

  • Continue and review periodically

Target IOP not reached:

  • Try an alternative prostaglandin analogue or:
  • Try (or add) a beta-blocker - timolol or betaxolol

Target IOP not reached:

  • Add in a carbonic anhydrase inhibitor – brinzolamide or:
  • Add a sympathomimetic - brimonidine
  • Consider combination drops

Target IOP not reached:

  • Surgery or laser

Please remember to prescribe using the generic name, including combination eye drops.


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  • First line
  • Second line
  • Specialist
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