Can Glaucoma Drops Make You Tired? Understanding the Connection

October 9, 2025 •

4 min read

According to the American Academy of Ophthalmology, certain types of glaucoma eye drops, particularly beta-blockers and alpha-agonists, can cause systemic side effects like fatigue. While these medications are crucial for managing intraocular pressure and preserving vision, feeling unusually tired or drowsy can significantly impact daily life for many patients. This article explores the pharmacological reasons behind this side effect and provides practical strategies for managing it.

Quick Summary

Certain glaucoma medications, such as beta-blockers, alpha-adrenergic agonists, and oral carbonic anhydrase inhibitors, can cause drowsiness and fatigue due to systemic absorption. The extent of tiredness varies by medication type and individual sensitivity. Understanding the potential side effects and speaking with a doctor about dosage or alternative treatments is key to mitigating fatigue and ensuring effective glaucoma management.

Key Points

Beta-blockers can cause fatigue: Medications like timolol can be absorbed into the bloodstream, slowing your heart rate and leading to fatigue.
Alpha-agonists may cause drowsiness: Brimonidine and similar drops can have systemic effects that result in drowsiness and a dry mouth.
Oral CAIs have higher fatigue risk: Oral carbonic anhydrase inhibitors (e.g., acetazolamide) are more likely to cause significant fatigue and malaise than eye drop versions.
Prostaglandin analogs often have lower systemic side effects: Drops like latanoprost are less likely to cause fatigue, as they have minimal systemic impact.
Punctal occlusion can reduce systemic absorption: A simple technique of pressing on the inner corner of your eye after instilling drops can minimize medication entering the bloodstream and reduce systemic side effects.
Talk to your doctor about timing or alternative medications: Adjusting the dosing schedule to before bed or switching to a different class of medication are potential strategies for managing fatigue.

Why Do Some Glaucoma Drops Cause Fatigue?

While eye drops are applied locally, the medication can be absorbed into the bloodstream through the tear ducts, leading to systemic side effects. The risk and severity of fatigue depend on the drug class. Different types of glaucoma drops have different mechanisms of action, and some are more prone to causing systemic effects than others. For example, beta-blockers and alpha-adrenergic agonists are well-known culprits.

Beta-Blockers: Systemic Effects

Beta-blockers, such as timolol (Timoptic) and betaxolol (Betoptic), reduce intraocular pressure by decreasing the production of fluid within the eye. However, these same active ingredients, when taken orally, are used to treat heart conditions. When absorbed systemically from eye drops, they can affect the heart and central nervous system.

Slowed Heart Rate and Low Blood Pressure: Beta-blockers can slow the heart rate and lower blood pressure, which may lead to feelings of lethargy, fatigue, and dizziness.
Central Nervous System (CNS) Effects: The medication can cross the blood-brain barrier and cause mood changes, including depression and fatigue. This effect can be particularly noticeable in older adults.

Alpha-Adrenergic Agonists: CNS Depression

Alpha-adrenergic agonists, like brimonidine (Alphagan P), work by both reducing fluid production and increasing drainage. However, this class of drugs can cause central nervous system effects, leading to drowsiness and fatigue.

Drowsiness and Tiredness: Brimonidine is known to cause drowsiness or tiredness in some patients, affecting their ability to concentrate. This is particularly a concern for children and older adults.
Dry Mouth: Alpha-agonists can also cause dry mouth, which can indirectly contribute to feelings of fatigue or discomfort.

Carbonic Anhydrase Inhibitors (CAIs): Metabolic Changes

While available in both drop (e.g., dorzolamide) and oral (e.g., acetazolamide) forms, systemic side effects are more pronounced with the oral versions. Oral CAIs can cause fatigue, malaise, and memory issues due to their effect on metabolic balance.

Metabolic Acidosis: Oral CAIs can alter the body's acid-base balance, leading to fatigue and a general feeling of being unwell.
Tingling Sensations: Side effects like tingling in the hands and feet can also be a distraction, contributing to overall discomfort and fatigue.

Managing Fatigue from Glaucoma Drops

If you are experiencing fatigue from your glaucoma medication, it is crucial to speak with your doctor. They may be able to adjust your treatment plan to minimize side effects without compromising your eye health.

1. Communicate with your ophthalmologist: Describe your symptoms clearly. Your doctor can assess if your fatigue is indeed linked to the medication or if other factors, like sleep issues or other health conditions, are at play.

2. Adjust your dosing schedule: For some medications, shifting the timing can help. For instance, taking a once-daily dose in the evening before bed can help you sleep through the period when the medication is having its peak systemic effect.

3. Proper drop instillation technique: Punctal occlusion is a technique that can significantly reduce systemic absorption. By applying pressure to the inner corner of the eye after instilling the drop, you can prevent the medication from draining into the nasal passages and being absorbed into the bloodstream. This helps keep the medication where it is needed.

4. Consider alternative medications: Some classes of glaucoma drops, such as prostaglandin analogs, have a lower incidence of systemic side effects like fatigue. Your doctor may consider switching to a different class of medication or a preservative-free version.

5. Combine medications: In some cases, a combination therapy might be prescribed. Some medications are more potent than others, and a regimen involving multiple medications may offer a better side-effect profile for you.

Comparing Glaucoma Medication Classes and Fatigue Risk

The following table provides a quick overview of different classes of glaucoma drops and their potential to cause fatigue:


Glaucoma Medication Class	Examples	Mechanism	Fatigue Risk	Management Strategy
Prostaglandin Analogs	Latanoprost, Bimatoprost, Travoprost	Increase fluid outflow from the eye	Low	Generally well-tolerated with minimal systemic effects.
Beta-Blockers	Timolol, Betaxolol	Decrease fluid production in the eye	High	Consider punctal occlusion or evening dosing.
Alpha-Adrenergic Agonists	Brimonidine, Apraclonidine	Decrease fluid production and increase drainage	High	Be cautious with driving or operating machinery; consider evening dosing.
Carbonic Anhydrase Inhibitors (CAIs)	Dorzolamide (drops), Acetazolamide (oral)	Decrease fluid production	Moderate (drops), High (oral)	Oral forms have higher risk; discuss alternative options with a doctor.
Rho Kinase Inhibitors	Netarsudil	Increase fluid outflow through trabecular meshwork	Low	Minimal systemic side effects related to fatigue.

Conclusion: Prioritizing Eye Health While Managing Side Effects

It is essential to continue your prescribed glaucoma treatment, as consistency is key to protecting your vision. However, you do not have to endure debilitating fatigue in silence. By understanding the potential for systemic absorption, identifying which medication may be causing the problem, and working closely with your ophthalmologist, you can find a treatment plan that minimizes side effects and improves your quality of life. Simple changes, such as modifying your dosage time or using punctal occlusion, can make a significant difference in how you feel while effectively managing your eye pressure. The goal is to achieve both vision preservation and overall well-being. [https://www.aao.org/eye-health/diseases/glaucoma-eyedrop-medicine]

Authoritative Link

For more information on the side effects of various glaucoma medications, you can consult the Glaucoma Medication Guide from the Glaucoma Research Foundation.

Frequently Asked Questions

No, not all glaucoma drops cause fatigue. The likelihood of experiencing this side effect depends heavily on the medication class. Beta-blockers and alpha-adrenergic agonists are more commonly associated with systemic side effects like fatigue, whereas prostaglandin analogs have a lower risk.

Eye drops can make you tired because the medication, though intended for local use, can be absorbed into your bloodstream through the tear ducts. From there, it can affect your central nervous system or cardiovascular system, leading to systemic side effects like fatigue.

If you notice a correlation between starting or consistently using your eye drops and feeling unusually tired, drowsy, or weak, the medication may be the cause. It is important to rule out other factors and discuss your symptoms with your eye doctor.

Punctal occlusion is a technique used to minimize systemic absorption of eye drops. By gently pressing on the inner corner of your closed eye for a few minutes after application, you block the tear duct that drains the medication into your nasal passages and bloodstream.

No. It is extremely important not to stop taking your glaucoma medication without consulting your doctor first. Uncontrolled eye pressure can lead to irreversible vision loss. Always speak with your ophthalmologist about side effects and treatment alternatives.

Your doctor may suggest alternative medications with a lower risk of systemic side effects, such as prostaglandin analogs. Other options include laser therapy or adjusting your current medication's dosage or timing.

Yes, for some medications, the timing can help manage side effects. Taking a dose in the evening before bed allows you to sleep through the peak systemic effect, which can be helpful for managing drowsiness.