2.2 years ago
Brimonidine is so fast-acting that some ophthalmologists will use it (as one part of their protocol) in the treatment of emergency acute angle closure glaucoma.
[Brimonidine (Alphagan P)] is fast acting, its duration of of action is about 12hrs and its IOP reduction achieved is about 20-30%, by multiple mechanisms of action. Combination timolol and brimonidine is also an option.
Brimonidine is an Alpha agonist.
I have seen the combination Azopt plus Timolol used in this situation too. Azopt is a carbonic anhydrous inhibitor.
I don't have personal experience with any of those. But Timolol works very fast for me.
Prostaglandin-class drops will probably be slow-acting for everyone (or I should say, most people - probably somebody will come along who is an exception).
Interestingly, weight lifting works even faster than any of the glaucoma medications I have tested. The absolute fastest IOP reduction is achieved with one set of squats (even with light or moderate weight). Of course, the acute effect from exercise only lasts an hour or so. It's not a replacement for glaucoma medications. I am just saying that if you want a near instant and large magnitude decrease in IOP, this method is worth considering too.
But note that if you do the weightlifting incorrectly, it can raise your IOP! I would only recommend this approach to people who have a tonometer and can verify that they are getting the expected decrease in IOP from the activity.