This post won’t be of interest to you unless you, or someone you know, takes Cosopt eyedrops. (Also known as Dorzolamide HCl-Timolol Maleate Opthalmic Solution. Or, more colloquially, “Satan’s tears.”)


As I discovered to my regret, glaucoma can lead to permanent loss of vision, so it’s important to keep elevated intraocular pressure under control. Cosopt is one of the more powerful anti-glaucoma eyedrops. Unfortunately, it’s mildly acidic. It hurts. Imagine putting a drop of vinegar or lemon juice in your eye. Twice a day. Ouch.

Compliance is a problem.

In other words, people find excuses to skip their eyedrops because they hurt. I’ve been taking Cosopt (and a variety of other eyedrops) for nearly two years now. The morning dose doesn’t hurt so badly, but the evening dose has been really painful. And, weirdly, it’s worse when I’m the most tired. I didn’t understand why; I just gritted my teeth and put up with it. (With, I’m sorry to say, a daily dose of pretty loud obscenities.)

I had discussed the pain with my glaucoma doctor during my regular visits, and the advice was pretty much “Yep, that’s how it works; put up with it.” This week, however, I mentioned how it was worse when I was tired. He matter-of-factly replied “That’s because your eyes are dry.”

And that was, apparently, that. So I followed up with “What if I took lubricant drops before taking the Cosopt?” “Yes, that should help; just wait five minutes before the Cosopt.”

I use non-prescription Systane (preservative-free lubricating drops) when necessary during the day. For the last couple of days, I’ve been using them a few minutes before the Cosopt, and the difference is amazing. The Cosopt still hurts, but 90% less than before. Imagine a drop of seawater, not a drop of vinegar.

I’m posting this with a bit of search-engine optimization in the hope that someone searching for “cosopt pain” will find it, but feel free to forward to anyone you know with glaucoma. I wish I’d known this trick months ago!

(And it’s an interesting commentary on American medicine that my doctor — who I like and respect — didn’t volunteer this suggestion, but had to be dragged into agreeing with it.)


  1. On the one hand, so glad for you that you’re not in (as much) pain. On the other hand, I want to slap this doctor as hard as the other doctor who gave you the “bad news” (remember him). Effing first world doctors with a fourth world mentality.


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