D. Increases uveoscleral outflow – Explanation
Primary open-angle glaucoma: management
The majority of patients with primary open-angle glaucoma are managed with eye drops. These aim
to lower intra-ocular pressure which in turn has been shown to prevent progressive loss of visual
field.
| Medication | Mode of action | Notes |
| Prostaglandin analogues (e.g. Latanoprost) |
Increases uveoscleral outflow | Once daily administration
Adverse effects include brown pigmentation of the |
| Beta-blockers (e.g. Timolol) | Reduces aqueous production | Should be avoided in asthmatics and patients with
heart block |
| Sympathomimetics (e.g. Brimonidine, an alpha2- adrenoceptor agonist) |
Reduces aqueous production and increases outflow |
Avoid if taking MAOI or tricyclic antidepressants Adverse effects include hyperaemia |
| Carbonic anhydrase inhibitors (e.g. Dorzolamide) |
Reduces aqueous production | Systemic absorption may cause sulphonamide-like
reactions |
| Miotics (e.g. Pilocarpine) | Increases uveoscleral outflow | Adverse effects included a constricted pupil,
headache and blurred vision |
Surgery in the form of a trabeculectomy may be considered in refractory cases.
