Part 4 of 14 of “Adjusting the Faucet or Opening the Drain – Currently Available Methods to Treat the Plumbing Problem of Open Angle Glaucoma” | A San Gabriel Valley Optometric Society (SGVOS) Continuing Education Dinner Event – 2 hours CE | Featured Speaker: Dr. David Richardson, MD | April 12, 2017

Currently Available (FDA-approved) Medical Treatments (Oral Medication)

Carbonic Anhydrase Inhibitors (CAIs)

The Carbonic Anhydrase Inhibitors (CAIs) – Again, they turn on the faucet. But the oral ones are far more effective than the topical ones. So the oral ones, again, are Acetazolamide and Neptazane. The issue with the oral ones, though, is systemic side effects: transient myopia, frequent urination, light-headedness, paresthesias/Paresthesias – extremity tingling. These are all bothersome but they’re not horrible. What’s horrible is potentially (in your older patients) dehydration leading to falls, malaise, weight loss, GI symptoms, and hypokalemia. So we all say to our patients, “eat bananas” — bananas actually aren’t the best source of potassium. Much better would be pomegranates, which we now have in abundance here. And soon enough bananas won’t be available anyway. So you might as well start recommending pomegranates before bananas go extinct, metabolic acidosis, kidney stones, aplastic anemia, and death. So this is why you don’t see patients on Diamox chronically at least not too many of them. So those are medical treatments.

Learn the Costs and Side Effects for each of the commonly used FDA approved classes of glaucoma medications.

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