Ripasudil free base is primarily used in the treatment of glaucoma and ocular hypertension. It functions as a Rho kinase inhibitor, which helps to reduce intraocular pressure by increasing the outflow of aqueous humor from the eye. This makes it effective in managing conditions where elevated eye pressure could lead to optic nerve damage and vision loss. It is often administered as an ophthalmic solution, allowing for direct application to the eye to achieve localized effects with minimal systemic absorption. Its mechanism of action provides an alternative for patients who may not respond adequately to other classes of intraocular pressure-lowering medications.