glaucoma

Acute treatment to lower intraocular pressure includes topical beta-adrenergic antagonists (eg, timolol), miotic agents (eg, pilocarpine), and alpha-2 agonists (eg, apraclonidine), along with oral or intravenous acetazolamide and intravenous mannitol. Once the acute attack resolves, definitive treatment with peripheral iridotomy should be performed in both eyes. This procedure creates an additional pathway for aqueous humor to enter the anterior chamber, preventing future attacks. For long-term management, at least until iridotomy is performed, patients should be counseled to avoid medications that cause pupillary dilation, including nasal decongestants (eg, pseudoephedrine) and anticholinergic agents (eg, tricyclic antidepressants, tolterodine).

Backlinks