Which type of doctor is most likely to prescribe medication used to treat glaucoma?

October 10, 2025 •

4 min read

Globally, glaucoma is one of the leading causes of irreversible blindness, according to the World Health Organization. Knowing which type of doctor is most likely to prescribe medication used to treat glaucoma is essential for early intervention and preventing the progression of this sight-stealing disease.

Quick Summary

An ophthalmologist, a medical doctor specializing in comprehensive eye care and surgery, is the specialist most likely to prescribe glaucoma medication. Optometrists, however, can also prescribe medication, often co-managing the condition alongside an ophthalmologist, particularly for less complex cases.

Key Points

Ophthalmologists are the primary prescribers: For comprehensive treatment of glaucoma, an ophthalmologist (MD/DO) is the medical doctor most equipped to prescribe and manage medications.
Glaucoma specialists handle complex cases: These are ophthalmologists with advanced fellowship training who manage difficult-to-control or advanced glaucoma.
Optometrists can co-manage care: In many states, optometrists can prescribe glaucoma eye drops and are crucial for initial diagnosis and long-term monitoring of early-stage cases.
Medication options vary: Treatment often starts with daily eye drops, such as prostaglandin analogs or beta-blockers, but oral medications may also be used.
The severity of the disease determines the specialist: While an optometrist can start treatment, advanced or complex cases typically require referral to an ophthalmologist for surgery or advanced medical management.
Consistency is key for medication: To prevent vision loss, patients must use prescribed eye drops exactly as instructed by their doctor.

Glaucoma is a progressive eye condition that damages the optic nerve, often due to increased pressure within the eye. While the damage is irreversible, early and consistent treatment can significantly slow or halt its progression. The most common initial treatment is medication, typically in the form of prescription eye drops designed to lower intraocular pressure (IOP). However, determining the right doctor for your specific case involves understanding the roles of different eye care professionals.

The Role of Ophthalmologists

An ophthalmologist is a medical doctor (MD) or doctor of osteopathic medicine (DO) who has completed specialized medical and surgical training for comprehensive eye and vision care. Because they are licensed physicians, they have the broadest scope of practice for eye conditions and are the definitive specialists for diseases like glaucoma.

For medication management, an ophthalmologist will:

Provide a definitive diagnosis: Through a series of comprehensive tests, including measuring intraocular pressure and examining the optic nerve, the ophthalmologist confirms a glaucoma diagnosis.
Prescribe initial and advanced medications: They are authorized to prescribe all types of glaucoma medication, including eye drops and oral carbonic anhydrase inhibitors.
Monitor and adjust treatment: An ophthalmologist will closely monitor the disease's progression and the effectiveness of the medication, adjusting dosages or changing prescriptions as needed.
Perform surgery or laser procedures: If medications are insufficient, an ophthalmologist can perform surgical and laser treatments to improve fluid drainage and lower eye pressure.

Glaucoma Subspecialists

For complex or advanced cases, a patient may be referred to a glaucoma specialist. This is an ophthalmologist who has completed additional fellowship training focused specifically on glaucoma management and surgery. This advanced training makes them the most experienced professionals for treating the most difficult cases.

The Role of Optometrists

An optometrist (OD) is a primary healthcare provider for the eye. Their training focuses on vision care, but also includes diagnosing and managing certain eye diseases. Depending on state regulations, optometrists are authorized to prescribe medications, including eye drops for glaucoma.

In the management of glaucoma, an optometrist can:

Perform initial screenings: They conduct comprehensive eye exams that can detect early signs of glaucoma, such as high intraocular pressure or optic nerve damage.
Prescribe medication: In many jurisdictions, optometrists can prescribe the initial regimen of eye drops to control eye pressure for early-stage glaucoma.
Provide co-management: It is common for optometrists and ophthalmologists to work together. The optometrist handles routine monitoring and follow-up care, while the ophthalmologist provides a definitive diagnosis and manages more complex interventions.
Offer referrals: For cases that are advanced, difficult to control, or require surgery, an optometrist will refer the patient to an ophthalmologist for specialized care.

Comparing Eye Care Specialists for Glaucoma Treatment

Deciding between an optometrist and an ophthalmologist for glaucoma care depends on the severity and complexity of the condition. Here is a comparison of their respective roles in treatment:


Feature	Optometrist (OD)	Ophthalmologist (MD/DO)	Glaucoma Specialist (Fellowship-Trained Ophthalmologist)
Education & Training	4-year optometry school	4 years college, 4 years medical school, 1-year internship, 3+ years residency	4 years college, 4 years medical school, 1-year internship, 3+ years residency, 1-year fellowship
Prescribing Medication	Can prescribe eye drops and some oral medications (scope varies by state)	Can prescribe and manage all eye-related medications	Can prescribe and manage all eye-related medications, specializing in complex cases
Diagnosing Glaucoma	Can diagnose glaucoma during a comprehensive eye exam	Provides definitive diagnosis and management plan	Specializes in complex or advanced diagnoses
Surgical Treatment	Does not perform surgery; provides pre- and post-operative care	Performs laser and traditional incisional surgery	Performs advanced and complex laser and surgical procedures
Primary Role	Primary eye care, early detection, and routine monitoring	Comprehensive medical and surgical eye care	Specialized management of complex glaucoma
Best For	Routine eye exams, managing early-stage glaucoma, and co-management with an ophthalmologist	All stages of glaucoma, especially those requiring potential surgical intervention	Advanced cases, surgical candidacy, and second opinions

Common Glaucoma Medications

Medications for glaucoma primarily work by lowering intraocular pressure, either by reducing fluid production in the eye or improving its drainage. These medications are most often prescribed as eye drops and must be used exactly as directed.

Prostaglandin Analogs: A common first-line treatment, these increase the outflow of fluid from the eye. Examples include latanoprost (Xalatan) and bimatoprost (Lumigan).
Beta-Blockers: These reduce the amount of fluid the eye produces. Common examples include timolol (Betimol, Timoptic).
Alpha-Adrenergic Agonists: These work to both reduce fluid production and increase outflow. Brimonidine (Alphagan P) is a well-known example.
Carbonic Anhydrase Inhibitors: Available as eye drops (dorzolamide) or oral pills (acetazolamide), these also decrease fluid production.
Rho Kinase Inhibitors: This newer class of medication, such as netarsudil (Rhopressa), helps to increase fluid outflow.

Conclusion

While an optometrist can diagnose glaucoma and initiate treatment with medication, the doctor most likely to prescribe medication and manage the full spectrum of glaucoma care is an ophthalmologist. For complex or advanced cases, a fellowship-trained glaucoma specialist, a subspecialist within ophthalmology, offers the highest level of expertise. Regular eye exams with either an optometrist or ophthalmologist are key to early detection and management. If you receive a glaucoma diagnosis from an optometrist, a collaborative approach that includes an ophthalmologist is often recommended to ensure the most comprehensive and effective care. For more information on glaucoma treatment options, you can consult resources like the Mayo Clinic.

Frequently Asked Questions

Yes, in many states, an optometrist (OD) can prescribe medication, most often eye drops, for the initial management of glaucoma. However, their scope of practice can vary by state, and they will typically refer complex or advanced cases to an ophthalmologist.

An ophthalmologist is a medical doctor who can provide comprehensive medical and surgical care for all eye conditions, including glaucoma surgery. An optometrist is a primary eye care provider who can diagnose and manage glaucoma medically but cannot perform surgery.

A glaucoma specialist is a fellowship-trained ophthalmologist who is recommended for complex or advanced cases where standard medications or procedures are not proving effective. They have additional expertise in complex medical and surgical management.

Most glaucoma medications are eye drops that work by either increasing the drainage of fluid from the eye or reducing its production to lower intraocular pressure. Common types include prostaglandins, beta-blockers, and carbonic anhydrase inhibitors.

If eye drops are not effective enough, a doctor may prescribe a combination of drops, recommend oral medication, or suggest laser therapy or surgery. These procedures aim to improve fluid drainage or create an alternative drainage pathway.

Yes, co-management between an optometrist and an ophthalmologist is common. The optometrist may handle routine checkups and initial medication, while the ophthalmologist oversees more advanced aspects of treatment.

No, while your primary care doctor might refer you to an eye specialist, they do not prescribe medications specifically for glaucoma. You need to see an eye doctor (optometrist or ophthalmologist) for a glaucoma diagnosis and treatment.