Condition

Glaucoma

Eye condition damaging the optic nerve

80M
People Affected
250
Active Trials
1.8M
New Cases/Year
8,000
Deaths/Year

Treatment Rankings

Ranked by evidence volume first. Medicine has spent centuries ranking things by vibes. This is an improvement.

1
Latanoprost
88% Effectiveness• 95% Confidence• 75% Safety• 251 trials• 200K participants
HIGH EvidenceExcellent ValueDose: One drop in affected eye(s) once daily in the evening
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
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Morphine💊
Antibiotics💉
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75
DangerousModerateSafe

Time to Effect

3-4 hours (maximal 8-12 hours)

Duration

Lifetime

Response Rate

85%

Remission Rate

%

Common Side Effects:

Eyelash growth (hypertrichosis): 30%
Iris pigmentation change: 10%
Conjunctival hyperemia: 8%
Ocular pruritus (itching): 4%
Burning/stinging upon instillation: 4%

Annual Cost of Care

Drug Cost

$360

Monitoring

$600

Side Effects

$50

Total Annual

$1,010

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.8

ICER

$25,000/QALY

Cost per Responder

$1,188

Treatment Outcomes
Primary Outcomes
Mean Diurnal Intraocular Pressure25 mmHg
-30% (-7.5 mmHg)
Peak Intraocular Pressure28 mmHg
-32% (-9.0 mmHg)
Intraocular Pressure Fluctuation (Standard Deviation)3.5 mmHg (standard deviation)
-15% (-0.5 mmHg)
Secondary Benefits
Glaucoma-Specific Quality of Life (GQL-15)GQL-15 score: 35/60
-14% (-5 points)
Ocular Perfusion Pressure (Mean)65 mmHg
+12% (+7.5 mmHg)
Common Side Effects
Eyelash growth (hypertrichosis)
+30%
Iris pigmentation change
+10%
Conjunctival hyperemia
+8%

Clinical Trial Phases:

Phase 4
2
Timolol
82% Effectiveness• 95% Confidence• 70% Safety• 266 trials• 180K participants
HIGH EvidenceExcellent ValueDose: One drop in affected eye(s) 1-2 times daily (0.25% or 0.5%)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

30 minutes (maximal 1-2 hours)

Duration

Lifetime

Response Rate

75%

Remission Rate

%

Common Side Effects:

Ocular stinging/burning: 7%
Dry eyes: 3%
Bradycardia (slow heart rate): 2%
Bronchospasm (in susceptible individuals): 0.5%
Headache: 3%

Annual Cost of Care

Drug Cost

$240

Monitoring

$600

Side Effects

$100

Total Annual

$940

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.7

ICER

$15,000/QALY

Cost per Responder

$1,253

Treatment Outcomes
Primary Outcomes
Intraocular Pressure (IOP) - Peak Effect25 mmHg
-25% (-6.25 mmHg)
Intraocular Pressure (IOP) - Trough Effect24 mmHg
-20% (-4.8 mmHg)
Diurnal IOP Fluctuation Range8 mmHg
-15% (-1.2 mmHg)
Secondary Benefits
Aqueous Humor Production Rate2.5 µL/min
-30% (-0.75 µL/min)
Ocular Perfusion Pressure (Mean)65 mmHg
+9.6% (+6.25 mmHg)
Average Number of Concomitant IOP-Lowering Medications1.5 medications
-33.3% (-0.5 medications)
Common Side Effects
Ocular stinging/burning
+7%
Dry eyes
+3%
Bradycardia (slow heart rate)
+2%

Clinical Trial Phases:

Phase 4
3
Selective Laser Trabeculoplasty (SLT)
80% Effectiveness• 90% Confidence• 80% Safety• 63 trials• 30K participants
HIGH EvidenceExcellent Value
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
80
DangerousModerateSafe

Time to Effect

Hours to days (maximal 4-6 weeks)

Duration

Effect typically lasts 1-5 years, repeatable

Response Rate

75%

Remission Rate

%

Common Side Effects:

Transient intraocular pressure spike: 7%
Mild ocular inflammation: 6%
Pain/discomfort during procedure: 3%

Annual Cost of Care

Drug Cost

$50

Monitoring

$600

Side Effects

$20

Total Annual

$1,003

Cost-Effectiveness

EXCELLENT

QALYs Gained

0.7

ICER

$5,000/QALY

Cost per Responder

$1,337

Treatment Outcomes
Primary Outcomes
Intraocular Pressure (IOP)24 mmHg
-25% (-6 mmHg)
Number of IOP-Lowering Medications2 medications
-50% (-1 medication)
Diurnal IOP Fluctuation5 mmHg
-20% (-1 mmHg)
Secondary Benefits
Glaucoma-Specific Quality of Life (GQL-15 score)GQL-15 score: 8
-25% (-2 points)
Ocular Surface Disease Index (OSDI score)OSDI score: 35
-20% (-7 points)
Annual Glaucoma Medication Cost$1200
-50% (-$600)
Common Side Effects
Transient intraocular pressure spike
+7%
Mild ocular inflammation
+6%
Pain/discomfort during procedure
+3%

Clinical Trial Phases:

Phase 4
4
Brimonidine
75% Effectiveness• 90% Confidence• 65% Safety• 105 trials• 70K participants
HIGH EvidenceGood ValueDose: One drop in affected eye(s) 2-3 times daily (0.1%, 0.15%, or 0.2%)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
65
DangerousModerateSafe

Time to Effect

1 hour (maximal 2-8 hours)

Duration

Lifetime

Response Rate

65%

Remission Rate

%

Common Side Effects:

Ocular allergy: 15%
Dry mouth: 18%
Fatigue/drowsiness: 10%
Ocular burning/stinging: 7%
Headache: 7%

Annual Cost of Care

Drug Cost

$480

Monitoring

$600

Side Effects

$100

Total Annual

$1,180

Cost-Effectiveness

GOOD

QALYs Gained

0.5

ICER

$40,000/QALY

Cost per Responder

$1,815

Treatment Outcomes
Primary Outcomes
Intraocular Pressure (IOP) (Peak Effect)26 mmHg
-28% (-7.28 mmHg)
Intraocular Pressure (IOP) (Trough Effect)25 mmHg
-20% (-5.0 mmHg)
Mean Diurnal Intraocular Pressure24 mmHg
-22% (-5.28 mmHg)
Secondary Benefits
Optic Nerve Head Blood Flow100 arbitrary units
+15% (+15 arbitrary units)
Visual Field Mean Deviation Progression RateAnnual MD loss: -1.0 dB/year
+20% (Rate slowed by +0.2 dB/year)
Retinal Nerve Fiber Layer (RNFL) Thinning RateAnnual RNFL thinning: -1.5 µm/year
+10% (Rate slowed by +0.15 µm/year)
Common Side Effects
Ocular allergy
+15%
Dry mouth
+18%
Fatigue/drowsiness
+10%

Clinical Trial Phases:

Phase 4
5
Dorzolamide
70% Effectiveness• 90% Confidence• 70% Safety• 79 trials• 60K participants
HIGH EvidenceGood ValueDose: One drop in affected eye(s) 2-3 times daily (2%)
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Comparative Safety Scale(Higher is safer)

Cyanide☠️
Meth💀
Cigarettes🚬
Chemo☢️
Alcohol🍺
Morphine💊
Antibiotics💉
Tylenol💊
Exercise🏃
Water💧
70
DangerousModerateSafe

Time to Effect

30 minutes (maximal 2 hours)

Duration

Lifetime

Response Rate

60%

Remission Rate

%

Common Side Effects:

Ocular stinging/burning: 20%
Bitter taste: 12%
Ocular allergy: 8%
Superficial punctate keratitis: 7%

Annual Cost of Care

Drug Cost

$540

Monitoring

$600

Side Effects

$50

Total Annual

$1,190

Cost-Effectiveness

GOOD

QALYs Gained

0.4

ICER

$55,000/QALY

Cost per Responder

$1,983

Treatment Outcomes
Primary Outcomes
Mean Diurnal Intraocular Pressure (IOP)26 mmHg
-20% (-5.2 mmHg)
Peak Intraocular Pressure (IOP)30 mmHg
-22% (-6.6 mmHg)
Trough Intraocular Pressure (IOP)24 mmHg
-18% (-4.32 mmHg)
Secondary Benefits
Intraocular Pressure Fluctuation (Diurnal Range)8 mmHg
-15% (-1.2 mmHg)
Ocular Perfusion Pressure (OPP)67 mmHg
+7.76% (+5.2 mmHg)
Common Side Effects
Ocular stinging/burning
+20%
Bitter taste
+12%
Ocular allergy
+8%

Clinical Trial Phases:

Phase 4