What Xalatan (Latanoprost) Is

Xalatan (latanoprost) is a prostaglandin analog administered as a topical ophthalmic solution (eye drops). It works by increasing uveoscleral outflow of fluid from the eye, thereby reducing intraocular pressure. Latanoprost is FDA-approved for the treatment of open-angle glaucoma and ocular hypertension. It is typically administered once daily, usually in the evening. Latanoprost has a strong safety profile with minimal systemic absorption and generally mild, localized side effects. It is considered a first-line or adjunctive therapy for glaucoma management.

What Is Glaucoma?

Glaucoma is an eye disease characterized by elevated intraocular pressure that damages the optic nerve, potentially leading to vision loss or blindness if left untreated or poorly controlled. There are several types of glaucoma, including open-angle glaucoma (the most common), angle-closure glaucoma, and others. Early-stage glaucoma often has no symptoms, making regular eye exams critical for early detection. Glaucoma is manageable when detected early and treated consistently with medication, laser therapy, or surgery. With appropriate treatment and monitoring, many people with glaucoma maintain normal vision throughout their lives.

Why Insurers View Glaucoma Carefully

Glaucoma is a serious eye condition that requires ongoing medical management and monitoring. Life insurers recognize this and evaluate glaucoma applicants carefully. However, underwriters also recognize that glaucoma is common, often highly manageable, and that with consistent treatment, most people maintain good vision and quality of life. The key factor in underwriting is disease control: is your intraocular pressure within target range? Is your vision stable? Are you compliant with treatment? These factors determine whether a glaucoma applicant receives favorable underwriting or faces higher rates or denial.

Ocular Hypertension vs. Glaucoma

Ocular hypertension is elevated intraocular pressure without optic nerve damage or vision loss. Some people with ocular hypertension develop glaucoma over time, while others never do. Xalatan is used to treat both conditions. Ocular hypertension alone has a better prognosis and receives more favorable underwriting than established glaucoma. However, many individuals with ocular hypertension are never diagnosed with glaucoma, and underwriters recognize this as a relatively low-risk condition when intraocular pressure is well-controlled.

Glaucoma Type and Severity

Underwriters first assess what type of glaucoma you have. Open-angle glaucoma (the most common type) is often managed well with medication alone and receives favorable underwriting. Angle-closure glaucoma or secondary glaucoma may be more complex and require closer evaluation. The severity of optic nerve damage at diagnosis also matters—early-stage glaucoma with minimal nerve damage has a better prognosis than advanced glaucoma with significant optic nerve deterioration.

Intraocular Pressure Control

The most critical factor for life insurance underwriting is whether your intraocular pressure (IOP) is at or below your ophthalmologist’s target range. Target IOP varies by individual but is typically in the range of 12-20 mmHg for well-controlled glaucoma. Underwriters will request your most recent eye exam results and IOP measurements. Consistently controlled IOP is a strong positive indicator for approval and rates. Elevated IOP despite medication suggests disease progression or treatment inadequacy and raises underwriting concerns.

Vision Status and Stability

Underwriters evaluate your current visual acuity (how well you see) and whether your vision has remained stable over time. Stable or improving vision is favorable. Vision loss, even mild or asymptomatic peripheral vision loss detected on visual field testing, raises underwriting concerns. However, stable vision despite a glaucoma diagnosis typically receives favorable underwriting, as it indicates the disease is well-managed and progression has been halted.

Compliance and Treatment Response

Underwriters assess whether you are compliant with prescribed medication and eye exams. Regular use of Xalatan as prescribed and consistent ophthalmology follow-up are positive factors. Poor compliance—missed doses, skipped eye exams, or failure to initiate prescribed treatments—raises red flags about disease management and increases underwriting risk.

Treatment History and Interventions

Underwriters review whether you have undergone laser treatment (trabeculoplasty) or glaucoma surgery. These interventions are common in glaucoma management and do not negatively impact underwriting when successful. If you have had multiple surgeries or interventions, underwriters may probe more deeply into disease severity and control. However, appropriate surgical intervention for glaucoma is viewed favorably as evidence of comprehensive management.

Overall Health Profile

Glaucoma is evaluated as one component of your overall health. Your age, other medical conditions, lifestyle factors, and general health status all matter. A younger applicant with well-controlled glaucoma and excellent overall health is underwritten more favorably than an older applicant with glaucoma plus multiple other health issues. However, glaucoma itself is typically not disqualifying or heavily rate-increasing if well-managed.

Xalatan and Other Eye Medications

You must disclose all eye medications on your life insurance application. Include Xalatan (latanoprost) on your medication list with the dosage, frequency, and indication. For example: “Xalatan (latanoprost) ophthalmic solution, one drop daily in both eyes for glaucoma management.” If you take other glaucoma medications (such as beta-blockers, prostaglandin analogs, or CAI inhibitors), disclose those as well.

Glaucoma Diagnosis

Always disclose your glaucoma diagnosis with specific details. Include the type of glaucoma (open-angle, angle-closure, etc.), the date of diagnosis, and your current disease status. For example: “Primary open-angle glaucoma diagnosed in 2019; well-controlled on Xalatan monotherapy; intraocular pressure stable at 15-16 mmHg bilaterally.” Be specific about whether your condition is stable or progressive. Underwriters view well-controlled, stable glaucoma very differently from progressive or poorly controlled disease.

Vision Status

Disclose your current vision status. Include your best-corrected visual acuity (e.g., “20/20 bilaterally” or “20/25 OD, 20/20 OS”). If you have experienced any vision loss, be honest about it and provide context. For example: “Mild peripheral visual field loss in right eye noted on visual field test in 2023; stable on repeat testing 2024.” Transparent reporting of vision status, even if imperfect, is far better than omission of material facts.

Intraocular Pressure Measurements

Provide your most recent intraocular pressure measurements if known. IOP is measured during routine eye exams and is critical information for underwriting. If your latest eye exam was within the past 6 months, provide those IOP values. If your IOP is consistently within or below the target range, emphasize that. If IOP is elevated despite treatment, be candid about it and explain any plans to optimize therapy.

Treatment History

Disclose your complete glaucoma treatment history. Include all eye medications you’ve taken (past and current), laser treatments, and any glaucoma surgeries. For example: “Failed trial of timolol monotherapy; responded well to Xalatan monotherapy; underwent successful selective laser trabeculoplasty (SLT) in right eye in 2022 with IOP reduction to target.” This demonstrates a comprehensive approach to disease management and helps underwriters understand your clinical course.

Ophthalmology Follow-Up

Include information about your ophthalmology follow-up schedule and compliance. For example: “Regular eye exams every 4-6 months with complete ophthalmology workup including visual field testing and optic nerve imaging.” Consistent follow-up demonstrates responsible disease management and commitment to early detection of progression. This is a positive factor in underwriting.

Scenario 1: Ocular Hypertension, Well-Controlled

Situation: You have ocular hypertension (elevated IOP without optic nerve damage) managed with Xalatan monotherapy. IOP consistently in the 18-20 mmHg range. No vision loss. Regular ophthalmology follow-up with stable visual fields.

Underwriting Outcome: Favorable. Ocular hypertension is a risk factor but not a disease like glaucoma. Well-controlled IOP with no vision loss is viewed favorably. You will likely be approved at standard or near-standard rates.

Expected Result: Standard rates; approval likely within 2-3 weeks.

Scenario 2: Primary Open-Angle Glaucoma, Early-Stage, Well-Controlled

Situation: You were diagnosed with early-stage primary open-angle glaucoma (POAG) 2-3 years ago. Minimal optic nerve damage at diagnosis. Currently on Xalatan monotherapy with IOP stable at 14-16 mmHg (at target). Vision is 20/20 with stable visual fields on repeat testing.

Underwriting Outcome: Moderately favorable. Early-stage, well-controlled POAG is manageable. Underwriters recognize that with appropriate treatment and monitoring, most people with early glaucoma maintain normal vision. You will be approved, likely at standard or slightly elevated rates.

Expected Result: Standard to slightly elevated rates; approval likely within 3 weeks with ophthalmology records.

Scenario 3: Primary Open-Angle Glaucoma, Advanced, Well-Controlled

Situation: You have had advanced POAG diagnosed 8+ years ago with significant optic nerve cupping at diagnosis. However, IOP has been maintained well below target (12-14 mmHg) with Xalatan plus timolol. Visual acuity remains 20/20. Recent visual field shows stable but reduced peripheral vision; no progression on repeat testing.

Underwriting Outcome: Mixed. Advanced glaucoma is more serious than early disease, but the fact that the disease is stable and not progressing over many years is a positive sign. Underwriters will carefully review medical records. Approval is likely, but rates may be moderately to significantly elevated, reflecting the severity of optic nerve damage and ongoing disease burden.

Expected Result: Moderately to higher rates; approval likely within 3-4 weeks with detailed ophthalmology records.

Scenario 4: Glaucoma with Progressive Vision Loss Despite Treatment

Situation: You have glaucoma with documented progressive visual field loss over the past 2-3 years despite multiple medications (Xalatan, timolol, and recently added brinzolamide). IOP remains borderline at 18-20 mmHg. Multiple ophthalmology visits, but the disease appears to be progressing.

Underwriting Outcome: More challenging. Progressive glaucoma despite aggressive treatment is a concern for future vision loss and disease burden. Underwriters will likely request detailed records and may ask whether additional interventions (laser or surgery) have been considered. Approval may still be possible, but would likely be at higher rates or with conditions (such as a requirement for additional ophthalmology documentation).

Expected Result: Moderately to significantly elevated rates possible; approval not guaranteed; underwriting may extend 4+ weeks or may require specialized underwriting.

Scenario 5: Glaucoma with Significant Vision Loss

Situation: You have glaucoma with significant vision loss (e.g., visual acuity reduced to 20/50 or worse in at least one eye, or substantial peripheral visual field loss affecting activities of daily living).

Underwriting Outcome: Complex underwriting required. Significant vision loss affects quality of life, safety, and overall health status. Underwriters will evaluate whether your remaining vision is stable or still declining, your functional status, and overall health. Approval may be possible, but rates will likely be elevated, and specialized carriers may be needed. In rare cases, denial may occur if vision loss is severe and affects independence.

Expected Result: Specialized underwriting required; approval uncertain; rates likely significantly elevated if approved; timeline 4-6+ weeks.

Step 1: Get Recent Ophthalmology Records

Before applying, schedule an appointment with your ophthalmologist and request comprehensive documentation. Ensure you have records from the past 6-12 months, including current IOP measurements, visual acuity, visual field test results, and optic nerve assessment. Recent, comprehensive ophthalmology documentation speeds underwriting significantly and demonstrates active disease management.

Step 2: Optimize Disease Control Before Applying

If your IOP is not at target or if your disease control is suboptimal, work with your ophthalmologist to optimize therapy before applying for insurance. A medication adjustment, laser treatment, or other intervention may bring your IOP down and improve your underwriting outcome. Applying with optimized glaucoma control is almost always better than applying with poorly controlled disease.

Step 3: Provide Comprehensive Glaucoma Details

When completing your application, be as specific and detailed as possible about your glaucoma. Include diagnosis date, type of glaucoma, current medications, recent IOP measurements, visual field status, and any interventions (laser or surgery). The more detail you provide, the clearer the picture becomes for underwriters and the more likely they are to make a favorable decision.

Step 4: Emphasize Disease Stability

Highlight that your glaucoma is stable. If your IOP has been consistently within target range and your vision has been stable on repeat testing, emphasize that. Stability is the most important positive prognostic factor for glaucoma. If you have had this disease for many years with no progression, make that clear—it demonstrates that your treatment regimen is effective.

Step 5: Demonstrate Compliance and Engagement

Make clear that you are compliant with prescribed treatment. If you take Xalatan every day as prescribed and attend regular eye exams, say so. If you have undergone recommended interventions (laser or surgery), mention that. Underwriters view compliance and engagement as positive signs of responsible health management and better long-term prognosis.

Step 6: Work with an Experienced Agent

An experienced insurance agent familiar with glaucoma and ophthalmic conditions can guide your application effectively. Agents understand which carriers are most favorable for glaucoma applicants and can help present your case optimally. They can also advocate with underwriters if questions arise. This professional guidance significantly improves your chances of approval and favorable rates.

Will glaucoma keep me from getting life insurance?

Direct answer: No. Life insurance is available for glaucoma patients.

Glaucoma is a manageable condition that many people live with for decades while maintaining good vision. Life insurers recognize this and underwrite glaucoma applicants regularly. Approval rates for glaucoma are high (70-85%), especially for those with well-controlled disease. Glaucoma alone will not prevent you from obtaining life insurance.

Will my life insurance rates be higher because of glaucoma?

Direct answer: Possibly, but not necessarily. Rates depend on disease control.

Many glaucoma applicants receive standard rates. Rate increases depend on disease severity, control status, and vision status. Early-stage, well-controlled glaucoma may not result in a rate increase. Advanced glaucoma or poorly controlled disease is more likely to result in a moderate to significant rate increase. Work with your ophthalmologist to optimize disease control before applying—better control leads to better rates.

Do I have to disclose my glaucoma?

Direct answer: Yes. Always disclose your glaucoma diagnosis.

Glaucoma is a material medical fact that must be disclosed on life insurance applications. Include your diagnosis, the type of glaucoma, when you were diagnosed, and your current treatment. Also disclose all eye medications, including Xalatan. Full transparency is legally required and protects the validity of your policy. Honest disclosure of glaucoma will not negatively impact your application compared to non-disclosure.

What information do underwriters need from my eye doctor?

Direct answer: Recent eye exam records with IOP, vision status, and visual field results.

Underwriters typically request records from the past 6-12 months, including current intraocular pressure measurements (in both eyes), best-corrected visual acuity, results of visual field testing, and optic nerve assessment. If you have had retinal imaging or other testing, include that. The more complete your ophthalmology records, the smoother your underwriting process.

How long does underwriting take for glaucoma applicants?

Direct answer: 2-4 weeks typically; longer for complex cases.

Most glaucoma cases are underwritten within 2-4 weeks. If you have straightforward, well-controlled glaucoma and provide comprehensive records upfront, you may be approved in 2 weeks. Complex cases or those requiring additional information may take 4-6+ weeks. Providing complete ophthalmology documentation from the start speeds the process significantly.

Will I need vision testing as part of the life insurance exam?

Direct answer: Possibly, but not routinely. Underwriters rely on ophthalmology records.

Life insurance medical exams typically include basic health screening (blood pressure, cholesterol, blood work) but not comprehensive eye exams or visual field testing. Underwriters rely on your ophthalmologist’s records for vision and IOP information. In rare cases where underwriters have questions or need additional information, they may request an updated eye exam, but this is not routine.

What if my intraocular pressure is higher than the target?

Direct answer: Approval still possible, but underwriting will be more careful.

Elevated IOP despite treatment suggests the disease is not optimally controlled. This raises underwriting concerns but is not automatically disqualifying. Underwriters will want to understand why. Are you on an adequate dose? Have you been advised to add another medication or try a different therapy? Before applying, consider working with your ophthalmologist to optimize your treatment. Better IOP control before application will result in better underwriting outcomes.

What should I do if I’m declined or offered unfavorable rates?

Direct answer: Appeal or try other carriers; work to optimize disease control.

If you are declined or offered very high rates, you have options. Different carriers have different underwriting guidelines for glaucoma. An experienced insurance agent can shop your case with multiple carriers to find more favorable terms. Additionally, if your glaucoma control can be improved over the next few months, reapplying after optimization may result in better outcomes. Many applicants who are initially declined or offered poor rates are approved at better terms after improving disease control.