"Most powerful" is a relative term...some patients respond briskly to
one drop while others may have no response at all.  In my practice, I
have found that Cosopt and Lumigan generally have the best patient
responses in IOP-lowering.  Nevertheless, they are less well tolerated
than Timolol or Xalatan, as both of the former can cause significantly
more redness and irritation.  If a drop is uncomfortable and/or makes
your eye red, then you are less likely to use it.  That, consequently,
makes it LESS effective (if you use it every few days or just right
before returning to your doc for an IOP check, for instance).  It is
important to balance both IOP-lowering effects with tolerability.  In
addition, a doc must determine how advanced one's glaucoma damage is
and tailor treatment accordingly.  Thus, glaucoma management becomes a
little more of an art than a science.
--Rick Cohn, MD
Glaucoma Specialist
Winter Park, FL

"Most powerful" is a relative term...some patients respond briskly to
one drop while others may have no response at all.  In my practice, I
have found that Cosopt and Lumigan generally have the best patient
responses in IOP-lowering.  Nevertheless, they are less well tolerated
than Timolol or Xalatan, as both of the former can cause significantly
more redness and irritation.  If a drop is uncomfortable and/or makes
your eye red, then you are less likely to use it.  That, consequently,
makes it LESS effective (if you use it every few days or just right
before returning to your doc for an IOP check, for instance).  It is
important to balance both IOP-lowering effects with tolerability.  In
addition, a doc must determine how advanced one's glaucoma damage is
and tailor treatment accordingly.  Thus, glaucoma management becomes a
little more of an art than a science.
--Rick Cohn, MD
Glaucoma Specialist
Winter Park, FL

I used to use Pilocarpine and it worked well and very quickly. Not very
convenient (4 tmes a day) and is worsened my sight due to a cataract.

I use Cosopt and Xalatan these days.