The invention concerns in one embodiment a method for treating glaucoma or elevated IOP in a patient comprising administering to the patient an effective amount of a composition comprising an agent that modulates PAI-1 binding to vitronectin. In another embodiment, the invention concerns a method of manufacturing a compound to be used as a treatment for glaucoma or elevated IOP comprising providing a candidate substance suspected of modulating PAI-1 binding, selecting the compound by assessing the ability of the candidate substance to decrease the amount of active PAI-1 in the trabecular meshwork of a subject suffering from glaucoma or elevated PAI-1, and manufacturing the selected compound.