I have been a glaucoma suspect (pseudoexfoliation left eye…

The red eye experienced with Alphagan many times resolves after a few weeks of being on the drop, especially when artificial tears are used in conjunction with it for the first few weeks. However, many people have redness that does not resolve no matter how long being on the drop. Patients on Lumigan can get a red eye, though it is more commonly seen and more impressive usually in Alphagan. Does that make sense?

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Sorry--I've once again been locked out of the chat window. I've been trying to get back in for nearly 30 minutes and have finally been successful. Let me respond to your last comment.

Certainly being tired is a side effect of Alphagan that most people can't put up with--and yes, you're right, beta blockers do this as well. As you seem to be very informed about your treatments, I would assume that you are closing your eyes gently and holding pressure to your lacrimal sac for 1-2 minutes after instillation of your drops, is that correct? If not, these are maneuvers you can try to limit the systemic absorption of the Alphagan. Unfortunately, the fatigue experienced from Alphagan typically is not a side effect that tends to dissipate. You could certainly persist with it for several weeks to see if it does go away with you, but in my experience it often times doesn't. Now as to your other question about drops with less side effects...

It looks like you've tried Xalatan already. Of the three drops that comprise the prostaglandin analogues (the class that tends to have the least side effects and the best efficacy), you've already tried Xalatan and you are currently on Lumigan. The other, Travatan Z works fairly well and may cause a little less redness than Lumigan (typically moreso, though, than Xalatan), but patients tend to complain that it burns fairly intensely.

Other than the prostaglandin analogues, beta blockers, and alpha blockers like Alphagan, the other major class of glaucoma drops that is routinely used is the carbonic anhydrase inhibitors. Trusopt and Azopt comprise the two drops in this class that are on the market and used widely. By themselves they don't have amazing results typically, but have worked well for many people, especially when people are intolerant to many of the other drops. They are sulfa-derivatives which can be troublesome for many people who have sulfa allergies. Does all of this make sense?

Are you available to chat right now? Now might be a prime opportunity as my internet browser seems to be happily communicating with the chat window at the moment :) I'm happy to help you with your concerns or answer any other questions you have.

I'm sorry--didn't quite understand the last part there?

Well, I think one of the most important things to understand and remember is that despite the fact that the medicines that you are taking and/or may take for glaucoma tend to work pretty well for most people, they are essentially still just chemicals and any chemical in the eye has the potential to irritate it, and therefore produce redness, burning, itching, tearing, foreign-body sensation, light sensitivity, etc... I think one of the biggest things that I know that helps my glaucoma patients stay on their medicines and tolerate them is to take care of their tear film on a daily basis. At the very least this....

involves using artificial tears at least 3 or better yet 4 times per day to help maintain some equilibrium in the tear film. Unfortunately there are many other entities that can affect the tear film and cause it to be dysfunctional and one of these that applies to you is the loss of your sex hormones through menopause--that puts your tear film at a disadvantage already. Then when the weather is very dry such as in the middle of winter, with heaters blaring, it can cause even more dysfunction to the tear film. I would recommend using artificial tears regularly and also consider using hot compresses every morning on both eyes for five minutes. Doing both of these can really help make your eyes happier despite having to put chemicals in them daily. Does this make sense?