Medications Affecting Intraocular Pressure
Medications that Increase Intraocular Pressure
- The American College of Cardiology and the American Heart Association recommend that sympathomimetic agents, such as ephedrine and fenoldopam, be contraindicated in patients with a risk of increased intraocular pressure or glaucoma, as they can precipitate acute angle-closure glaucoma attacks through mydriasis (pupil dilation) 1, 2, 3
- These alpha-adrenergic agents cause pupil dilation, which reduces the outflow of aqueous humor through the trabecular meshwork 1, 2, 3
Medications that Reduce Intraocular Pressure
- Beta-blockers, both topical and oral, reduce intraocular pressure by decreasing aqueous humor production, according to the American Heart Association 5, 6
- Timolol 0.5% twice daily achieves reductions of approximately 7-9 mmHg in intraocular pressure 7
- Oral beta-blockers also reduce intraocular pressure when used for hypertension or heart disease 5, 6
- Prostaglandin analogs are the most prescribed eye drops for reducing intraocular pressure, with a mean relative reduction of 21.4% in the first 3 months, as recommended by the American Academy of Ophthalmology 8
- Carbonic anhydrase inhibitors, such as oral acetazolamide, provide a 20-30% reduction in intraocular pressure 9