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Glaucoma - Preservative-Free drops (Ophthalmology)

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Available Products in the U.S.

  • Cosopt® PF - Dorzolomide HCI & Timolol Maleate  Soln - 2%/0.5%:  
    : The dose is one drop of COSOPT PF in the affected eye(s) two times daily. [PRESERVATIVE-FREE]
  • Timolol maleate ophthalmic solution 0.25%, 0.5% in Ocudose dispenser  (PF):
    Dosing: The usual starting dose is one drop of 0.25% Preservative-free TIMOPTIC in OCUDOSE in the affected eye(s) administered twice a day. Apply enough gentle pressure on the individual container to obtain a single drop of solution. If the clinical response is not adequate, the dosage may be changed to one drop of 0.5% solution in the affected eye(s) administered twice a day.
  • Tafluprost ophthalmic solution 0.0015% (PF) (Zioptan™):
    : One drop in the affected eye(s) once daily in the evening. [Store refrigerated at 2° to 8°C (36° to 46°F). ]




  • Preservatives found in topical glaucoma medications usually have a number of toxic effects on the ocular surface.
  • Switching patients to a preservative-free product has been proven to significantly decrease signs and symptoms of ocular surface disease (OSD).
  • The ocular toxicity associated with preservatives not only impacts tolerability, but also compliance. Patients being treated for glaucoma frequently have issues with compliance.
  • Patients treated with preservative-free medications usually have healthier ocular surfaces and improved adherence.
  • The only potential drawbacks are potentially the increased cost and the risk of contamination if a patient saves the excess solution for a future application.

Thygesen J. Glaucoma therapy: preservative-free for all?. Clin Ophthalmol. 2018;12:707-717. Published 2018 Apr 13. doi:10.2147/OPTH.S150816

Conclusion:  There are a number of risk factors that can predispose to ocular surface disease (OSD) among glaucoma patients: long treatment duration, age, sex, working and leisure environments, multiple medical comorbidities and their associated medication, and ethnicity. In such patients, it seems reasonable to avoid an additional risk of OSD caused by exposing them to the preservatives in their glaucoma therapy.



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Glaucoma Preservative-Free drops