Toxicity of Ocular Medications

Ophthalmological Preparations

“…The b-blockers lower the IOP by decreasing aqueous humor production [72][73][74]. Although topical preparations are generally well tolerated, systemic (CNS, cardiovascular, and respiratory) side effects have been observed [72][73][74], [76][77][78]. …”

“…Effective oral doses of these agents for glaucoma therapy depend on their pharmacokinetic properties [72], [74], [79]. Systemic side effects [72], [74], [76], [79] may limit the use of oral carbonic anhydrase inhibitors, especially in the elderly. Unfortunately, no topically effective preparations of these agents are available, possibly due to poor corneal penetration.…”

“…These drugs may have significant side effects [72], [75], [76]. They are used primarily to treat acute IOP elevation and in ocular surgical procedures [72].…”

“…Muscarinic activation also constricts the pupillary sphincter and produces miosis, which is sometimes an undesirable side effect of antiglaucoma therapy. Other ocular and systemic side effects may be associated with the use of miotics for antiglaucoma therapy [72], [73], [76], [77], [80].…”

“…Enhancement of corneal penetration may be achieved with 0.03 % benzalkonium chloride (BAK) in the formulation, or with lower levels of BAK along with methyl cellulose or hydroxypropyl methyl cellulose to prolong contact with the ocular surface [73]. Carbachol is used when the response to pilocarpine is inadequate or when a pilocarpine allergy develops [73], [76].…”