The most common first-line treatment for glaucoma is to use an eye drop called a prostaglandin analog. There are several different medications in this class of medications. The purpose of these medications is to increase the drainage of fluid from the front of the eye and lower eye pressure. There are many potential side effects of these eye drops – but few of the side effects are serious or long-lasting.
Prostaglandin Analog Eye Drop Medications
The most common prostaglandin analog medication is latanoprost, or the brand name Xalatan. Other common medications in this class include travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan), and latanoprostene bunod (Vyzulta).
Each of these medications functions with the same mechanism of action and is functionally similar in nearly every way.
The most noteworthy difference is that tafluprost sold under the trade name Zioptan is formulated without any preservatives and packaged in individual vials.
Mechanism of Action of Prostaglandin Analogs
A prostaglandin analog increases inflammation in the eye and leads to an increase in cellular-level tissue repair.
By starting this cellular repair, the prostaglandin analog is able to create changes in the drainage system of the eye called the angle.
When the inflammatory repair occurs, the angle will be “cleaned” of extracellular debris and allow fluid to drain more efficiently.
Through this process, a prostaglandin analog can lower eye pressure by up to 30 percent.
Common Side Effects of Prostaglandin Analogs
All prostaglandin analogs have similar side effects – the most common two are burning upon instillation and general redness of the conjunctiva.
Additional but less common side effects include increased pigment in the iris and around the eyes, increased eyelash growth, and an increased risk for eye inflammation, especially with an active eye infection.
Burning or Stinging from Prostaglandin Analogs
Many eye drops have a listed side effect of burning upon installation because the eye drop is slightly acidic compared to the tear film.
Prostaglandin analogs are among these acidic eye drops. The drop may burn slightly when put into the eye.
A good option to minimize this side effect is to refrigerate the eye drops before putting them in at night.
Redness of the Conjunctiva
One common side effect of all the prostaglandin analogs is a generalized redness of the conjunctiva.
The conjunctiva is responsive to the inflammatory mechanism of the prostaglandin analog and will become bloodshot with prolonged use of the drops.
To minimize the symptoms of this side effect, the drops are instilled nightly before bed and the redness has mostly subsided by morning.
Increased Pigment from Prostaglandin Analogs
A side effect without a well-understood mechanism is the increase in pigmentation in the iris and the eyelid skin.
Prostaglandin analogs increase overall inflammation, and it is believed that this is the root of the color change.
In light-eyed individuals, the iris may become noticeably darker, or one iris appears to be colored differently than the other.
Increased Eyelash Growth from Prostaglandin Analog
Prostaglandin analogs have been shown to increase eyelash growth and thicken the existing lashes.
The inflammation effects of the prostaglandin analog lead to increased lash growth and voluminous increase in the eyelashes.
This side effect has become a marketable medication as a lash growth serum under the trade name Latisse.
Eye Inflammation from Prostaglandin Analogs
Since the main mechanism of action of prostaglandin analogs is to increase the inflammatory response of the eyes, a known risk is developing unwanted eye inflammation.
The biggest risk for this inflammatory response is when a concurrent herpes infection or mild inflammatory condition is already present.
Our eye doctors at Neal Eye Group in Conshohocken, PA excel in the prescription of contact lenses, glasses and various eye diseases. Call our optometrists at (610) 828-9701 or schedule an appointment online if you would like to learn more about prostaglandin analogs. Our optometrists provide the highest quality optometry services and eye exams in Conshohocken, Norristown, Plymouth Meeting, Lafayette Hill, and Philadelphia.
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