2020–2021 BCSC Basic and Clinical Science Course™
Chapter 12: Medical Management of Glaucoma and Ocular Hypertension
General Approach to Medical Treatment
Use of Glaucoma Medications in Elderly Patients
There are specific considerations regarding the use of glaucoma medications in elderly patients. First, elderly patients generally have greater difficulty instilling their medications than do younger patients; consequently, their adherence to the treatment regimen may be affected. Instillation difficulties may be due to tremor, poor coordination, or a comorbidity such as arthritis. Adherence may also be affected in elderly patients with reduced mental capacity or poor memory and a complicated drug regimen, especially because such individuals are often already taking multiple systemic medications for other ailments. Second, elderly persons have a greater susceptibility to systemic adverse effects of glaucoma medications. The incidence and severity of systemic adverse effects may be higher with β-blockers and α2-adrenergic agonists in these patients. For example, a significant proportion of asymptomatic elderly patients suffer a significant, but reversible, reduction in pulmonary function with the use of β-blockers.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.