Drugs for treating the eyes
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| bevacizumab | (1st gen) monoclonal antibody / Binds all forms of VEGF-A / Inhibit angiogenesis by inhibiting vascular endothelial growth factor (VEGF) binding to VEGF receptors / Contraindicated for ocular infections / Used for diabetic optic neuropathy | Some common side effects
• Conjunctival hemorrhage
• Vitreous floaters
• Eye infection that may include eye pain, light
sensitivity, vision changes.
• Increased intraocular pressure
• Cataract
• Vitreous detachment
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| ranibizumab | (2nd gen) antibody fragment / Binds all forms of VEGF-A better / Inhibit angiogenesis by inhibiting vascular endothelial growth factor (VEGF) binding to VEGF receptors / Contraindicated for ocular infections / Used for diabetic optic neuropathy | Some common side effects
• Conjunctival hemorrhage
• Vitreous floaters
• Eye infection that may include eye pain, light
sensitivity, vision changes.
• Increased intraocular pressure
• Cataract
• Vitreous detachment
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| aflibercept | (3rd gen) fusion protein / Binds VEGF-A, VEGF-B, and PGIF tightest / Inhibit angiogenesis by inhibiting vascular endothelial growth factor (VEGF) binding to VEGF receptors / Contraindicated for ocular infections / Used for diabetic optic neuropathy | Some common side effects
• Conjunctival hemorrhage
• Vitreous floaters
• Eye infection that may include eye pain, light
sensitivity, vision changes.
• Increased intraocular pressure
• Cataract
• Vitreous detachment
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| timolol | Beta adrenergic blocker / Agents that suppress aqueous inflow | Ocular irritation and dry eyes. Contraindicated in patients with
bradycardia, heart block, heart failure, asthma, or obstructive
airway disease.
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| brimonidine | Alpha-2 adrenergic agonist / Agents that suppress aqueous inflow and increase aqueous outflow | Red eye and ocular irritation. CNS effects and respiratory arrest
in young children (brimonidine). Caution in patients with
cerebral or coronary insufficiency, Raynaud phenomenon,
postural hypotension, hepatic or renal impairment.
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| dorzolamide | Carbonic anhydrase inhibitors (topical) / Agents that suppress aqueous inflow | Oral form can cause transient myopia, nausea, diarrhea, loss of appetite and taste, parasthesiae, lassitude, renal stones, and hematological problems. Topical forms much less likely to cause systemic side effects but can cause local irritation and redness
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| brinzolamide | Carbonic anhydrase inhibitors (topical) / Agents that suppress aqueous inflow | Oral form can cause transient myopia, nausea, diarrhea, loss of appetite and taste, parasthesiae, lassitude, renal stones, and hematological problems. Topical forms much less likely to cause systemic side effects but can cause local irritation and redness
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| bimatoprost | Prostaglandin analogues / Agents that increase aqueous outflow | Brown discoloration of iris, lengthening and darkening of
eyelashes, ocular irritation and redness, macular edema or iritis
in susceptible individuals
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| latanoprost | Prostaglandin analogues / Agents that increase aqueous outflow | Brown discoloration of iris, lengthening and darkening of
eyelashes, ocular irritation and redness, macular edema or iritis
in susceptible individuals
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| pilocarpine | Cholinergic agonists / Agents that increase aqueous outflow | Ciliary spasm leading to headaches especially in younger
patients, myopia, dim vision (small pupil). Cataracts and irislens
adhesions in long term.
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