Medical management of Glaucoma is done only or administrated as pre , intra and postoperative. the choice of initial treatment is based, in part, on the most appropriate means of IOP reduction and the type of glaucoma. They act by suppression and outflow facilitation. Those medical management are applied alone (monotherapy) or as combination therapy based on demands. Among them the most frequent and sometimes first line treatment is prostaglandins. PG analogs effectively reduce IOP by increasing aqueous humor outflow. Bimatoprost was related with significantly superior efficacy in lowering morning IOP than latanoprost. The cholinergic agonists work also primarily by its influence on aqueous outflow. This class of medications is not used as commonly as in the past. Pilocarpine is, however, an important medication to have available in the office in the presence of an acute ACG. Carbamylcholine lowers aqueous humor production in a greater extent than pilocarpine. The β-adrenergic antagonist is an aqueous suppressants were applied the first-line medication for glaucoma for many years and these days they are more commonly used as a second-line medication. The α agonists represent another class of glaucoma medication that function, mainly, as aqueous suppressants, however they may also facilitate outflow. Before offering of brimonidine, apraclonidine was the only available α-adrenergic agonist and was FDA approved for shortterm administration. The Carbonic Anhydrase Inhibitors are aqueous suppressants not routinely used as first-line medications in the treatment of glaucoma. this class of medication can lower IOP by ~20%, topical Carbonic Anhydrase Inhibitors are usually used as adjunctive therapy either as an additional separate administration or, more commonly, in a fixed combination with timolol maleate. Use of hyperosmotics in the United States is restricted to intravenous preparations. Hyperosmotics enhanced blood serum osmolarity, which pulls water from tissues into the blood. By increasing the osmotic gradient between plasma and the eye, vitreal dehydration occurs, which leads to reduced ocular volume and corresponding lowered IOP. The results are quite rapid (15 minutes to 2 hours) and short in duration (6 to 8 hours). Hyperosmotics are indicated when there is a necessity for rapid temporary reduction in high IOP.