Background: Commercially available prostaglandin analogues (PGAs) activate the prostaglandin F receptor (FP) reducing intraocular pressure (IOP), thereby stabilizing glaucomatous optic neuropathy. Poor adherence with eye drops and intolerance impact treatment success.

Methods: We review developments in drug formulation and delivery, including punctal plugs, topical ring inserts, subconjunctival injections and inserts, and intraocular inserts. We also outline research into new fixed dose combinations that include prostaglandin analogues and preservative-free versions of established agents.

Conclusions: Glaucoma is a chronic, usually progressive disease that causes irreversible visual loss. As its prevalence increases exponentially with age, it has significant implications as the population ages. Health resources need to meet increased demand for glaucoma management resources, including monitoring and treating glaucoma suspects and patients and supporting those who have suffered visual disability. Several promising therapies are under investigation. Sustained-release prostaglandin analogues using alternate delivery methods are encouraging. Delivery routes may be more invasive than topical drops. Nanotechnological-release delivery of prostaglandin analogues could lower IOP effectively. Approaches like this would eliminate many of the adherence issues associated with daily topical PGA eye drop use.