ABSTRACT
For various reasons, medical treatment of glaucoma has become more complicated lately; until 1995, only three large groups of topical glaucoma medications were available, namely cholinergic drugs, sympathomimetic drugs and b-blockers. In a very few countries, only a2-agonists such as clonidine were also available. With the advent of the topical carbonic anhydrase inhibitors in 1995, the armamentarium of the glaucoma specialist grew richer, soon followed by brimonidine, another a2-agonist, and a whole new class of substances, heralded by latanoprost. Until 1995, the ophthalmologist faced simple choices: if the patient did not like the narrow pupil, he avoided pilocarpin; and if he suffered from asthma or second degree atrioventricular block, he avoided b-blockers. Now, we can treat such a patient successfully, even if he has both or even more contraindications, but we also face the agony of choice.This is particularly true for the group of drugs often referred to as the prostaglandins. At first glance they appear to have fairly similar properties, but this is heavily disputed by their manufacturers and distributors.Thus, this chapter is divided into three parts.The first part will explain some of the similarities and differences of the various prostaglandins. The second part will look into advantages and disadvantages of this group, and in the third part, the chapter will try to give recommendations for the selection of a specific drug for a specific patient.
