Bimatoprost is a prostaglandin analogue (PGA) drop. These compounds were developed and came to market in the 90s. They radically changed how glaucoma is treatment and have helped preserve the vision of millions of people. Unfortunately, like many drugs, they have side effects. Some are acceptable, some are unacceptable, and some are tolerated to save vision. These drugs frequently cause eye irritation. They darken irises. That is perhaps not a big deal if you have a brown eye. But if you have a hazel eye, you may not appreciate loosing your eyes special color. Deepening of the upper eyelid sulcus (DUES) also known as prostaglandin associated periorbitopathy. The prostaglandin glaucoma drops caused a number of eyelid changes including meibomitis and blepharitis, eyelid fibrosis and stiffening, eyelid retraction, loss of periocular volume, and of course, eyelash growth. These changes also occur with the use of lash serum that contains prostaglandins like Latisse. Usually volume loss can be seen with in 4 months of initiating treatment. It is said that volume loss is reversible with discontinuation of the drops. However, I think there is some reason to question with proposition. The patients I have seen who have stop treatment have some degree of improvement but they simply do not return to normal. Regarding your specifics, I would not think that orbital implants would be a particularly good option. That is vision threatening surgery with loss of vision a known and well described potential complication. I would recommend talking to your ophthalmologist about alternatives to being on bimatoprost. Some of the other PGA drops have a lower rate of orbitopathy. Individual factors are very important. They question is why are you on bimatoprost? Is it saving your vision?
