Allergy to Cosopt

[JanD236]

My mum, who’s in her 80s, has had glaucoma for 30 years. I think this is normal tension glaucoma.

In the last 10 years she’s had a deep scelerotomy in one eye and a trabeculectomy in the other, also cataract surgery in one eye. Drops are continued in both eyes to keep pressures low. Her consultant had said that further surgery is not advised as her eyes are too fragile.

Over the last few months my mum has had increasing irritation in her eyes; redness, a gritty feeling, glued together eyelids in the morning, worsening vision, light sensitivity, extreme watering (she also has drops for dry eyes). This has become intolerable and her (private) consultant thought it is highly likely that she is allergic to one of the ingredients in her Cosopt drops. As surgery is not an option he advised that her choice is to continue with her current drops and keep her pressures under control or discontinue the drops and risk blindness within the next 10 years.

My mum has been taking Cosopt and Monopost for the last year or so and this regime has kept her pressures around 9.

Last week my mum had an NHS consultation and asked for her drops to be changed to ones previously used which didn’t irritate her eyes but kept her pressures controlled. She’s now been on Trusopt, Timtoptol and Monopost for the last few days, however, the irritation is as bad as ever.

Apologies for the length of the post but my question is, does anybody know which ingredient in Cosopt is the one she’s likely to be allergic to? If so, is this ingredient also in Trusopt or Timtoptol? If it is, is there any alternative?

My mum’s discomfort is so bad that she is now seriously considering stopping drops. I was hoping that at worst my mum could just stop the drops that contain the ingredient she’s allergic to and at best, she can find an alternative.

Thank you in advance.

[eyesong]

I hope this may help to pass it to her Dr. I take Cosopt PF 2 times a day and Zioptan PF at bedtime and both drops are PF preservative free. For 20 some years I had problems with the preservatives in drops. I also take a pill 2 times a day now/ Methazolamide 50 Mg tablet. I also use Erythromycin Ophthalmic ointment 0.5% on inside/outside eyelids at bedtime to cut down on Inflamation. I would trade my pressure for her pressure any day! Mine is just around 18/19 etc. and always goes back to that even after laser surgery several times and changing drops. I have good test results so will stay where I am until Stem Cell becomes the norm. My top Doctors tell me I have scar tissue from too much surgery. Best, Eyesong.

[chris4146 in reply to eyesong]

The thing with normal tension glaucoma,which I have,is you can have not a very high eye pressure,but it still damages the optic nerve,I don't think anyone knows why this happens unfortunately.

[JanD236]

Thank you for that information which I’ll pass on. It’s useful to hear about a tablet for glaucoma and the ointment.

My mum has also been using preservative free drops.

All the best.

[Trish_GlaucomaUK Partner]

Hello Jan,

It is worth your mother visiting her GP as she may have a slight eye infection.

Has your mother ever been diagnosed with Dry eye or Blepharitis? It sounds like, by your prescription that she may possibly have these. Especially as her eye are very sticky, gritty and sore in the morning.

Regarding eye drops, it tends to be the preservative that causes the eye to become sore and inflamed but if your mothers drops are all preservative free this should stop this from happening. Using a heated eye mask in the morning can help with the dryness of her eyes and it is important that she cleans her eyes gently in the morning when she wakes up. Dry eye drops during the day will also help and a gel form of eye lubricant may help her at night.

I have attached the PDF's of our literature on both Blepharitis and Dry Eye Disease for you to look at. If you would like a paper copy for your mother you can visit our website and order online.

glaucoma.uk/wp-content/uplo...

glaucoma.uk/wp-content/uplo...

[JanD236 in reply to Trish_GlaucomaUK]

Thanks for your reply, I’ll pass on the information to her.

My mum does have both dry eye and blepharitus.

[GlaucomaMe]

Hi Jan

I have Normal Tension Glaucoma, I was on both Monopost and Trusopt. Cosopt and Trusopt both contain dorzolamide. I had a very bad reaction to Trusopt, my eyes we’re red with that sore gritty feeling, much worse than dry eye. My eyes stung when I added the Trusopt. My consultant suggested stopping the Trusopt for a month to see what would happen, but continue with Monopost. Strangely my pressures dropped slightly from 11-ish to 10-ish. I questioned the consultant on this and he shrugged, saying most Glaucoma medicines are developed and tested on eyes with higher pressures. I am not suggesting that this would happen to your mum, but you might find that the Monopost is doing most of the pressure controlling. It is definitely worth asking that her medication be reviewed and different combinations tried to see if she can be made more comfortable whilst achieving reasonable pressures.

[JanD236 in reply to GlaucomaMe]

Thanks for your reply and I’ll talk to my mum about it.

Are you continuing on monopost only going forward?

[GlaucomaMe]

Yes, only Monopost. I have dry eyes, probably exasperated by the Monopost, but it is manageable. The Monopost alone holds my pressures at about 10, sometimes 9, sometimes 11. But different drugs work differently on different people. It is worth trying to get your mother the right combination for her. Glaucoma is slow moving it should not cause any significant damage to exclude or change drops and test once a month. Our hospital has a nurse who is trained to use the pressure testing equipment that the doctors use and so (prior to COVID) was okay to do more regular pressure testing.

[Nanatform in reply to GlaucomaMe]

Do you use monopost once or twice a day

[GlaucomaMe]

Once, at night, as prescribed by my consultant. I am aware that for some people my pressures are amazing, but I have never had high pressures yet have lost considerable amounts of vision, 50% in one eye. The Monopost is working on an already low pressure.

[Nanatform in reply to GlaucomaMe]

Thank you, it is so good to hear other people's experiences.I am going to try to just use the monopost for a few days, to see if there is any relief from my dry eyes etc.