EC Ophthalmology

Glaucoma remains one of the main burdens of preserving vision and vision related quality of life. Though probability of long-term preservation of vision has improved considerably in open-angle glaucoma for those who are diagnosed early and treated according to the modern glaucoma guidelines, the vision related quality of life may still be compromised by cosmetic effects and tolerance issues of the various topical glaucoma medications. Ocular hyperaemia remains the most common patient recognized problem of topical glaucoma medication. In order to avoid unnecessary patient anxiety and treatment cessation, understanding the reasons and types of ocular hyperaemia related to topical intraocular pressure lowering medication remains essential. The current Editorial gives an overview of the main types of medication induced ocular hyperaemia in glaucoma, and also guides the reader across actions, which are required from the managing ophthalmologist.

 Keywords: Glaucoma; Ocular Hyperaemia; Prostaglandin Analogue; Rho Kinase Inhibitor; Topical Glaucoma Medication

1. Global Burden of Disease 2019 Blindness and Vision Impairment Collaborators. Blindness and Vision Impairment Collaborators Vision Loss Expert Group of the Global Burden of Disease Study. “Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study”. The Lancet Global Health 2 (2021): e144-e160.
2. Holló G. “Ocular hyperemia associated with topical glaucoma medication - understanding and differentiating clinical appearance and underlying mechanisms”. Expert Opinion on Drug Safety 2 (2025): 145-156.
3. Holló G., et al. “Preservative-free prostaglandin analogs and prostaglandin/timolol fixed combinations in the treatment of glaucoma: efficacy, safety and potential advantages”. Drugs 1 (2018): 39-64.
4. Kóthy P and Holló G. “Real-life experience of using brinzolamide/brimonidine fixed drop combination in a tertiary glaucoma centre”. International Ophthalmology 2 (2020): 377-383.
5. Holló G. “The side effects of the prostaglandin analogues”. Expert Opinion on Drug Safety 1 (2007): 45-52.
6. Oddone F., et al. “Treatment of open-angle glaucoma and ocular hypertension with preservative-free tafluprost/timolol fixed-dose combination therapy: the VISIONARY study”. Advances in Therapy 4 (2020): 1436-1451.
7. Stalmans I., et al. “MERCURY-3: a randomized comparison of netarsudil/latanoprost and bimatoprost/timolol in open-angle glaucoma and ocular hypertension”. Graefe's Archive for Clinical and Experimental Ophthalmology 1 (2024): 179-190.