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Glaucoma is a painful disease that causes progressive loss of vision and frequently leads to blindness. Medical treatment of glaucoma remains a therapeutic challenge because of the numerous causes of the disease and the complexity of its pathogenesis. A large, almost bewildering, choice of available drugs, many of which have possible ocular or systemic side-effects as well as specific contraindications, further complicates the clinician’s task. This paper begins with a brief overview of the evolving definition of glaucoma It continues with a review of methods of classifying glaucoma, and their implications for treatment of the disease. Goals of treatment, principles of treatment, and the various classes of available drugs are described. The paper concludes with a discussion of recent advances in the understanding of the pathogenesis of glaucomatous loss of vision, and their therapeutic implications in the development of neuroprotective treatments for glaucoma.
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