A patient with primary open-angle glaucoma is on timolol 0.5% eye drops. He develops bradycardia and worsening of asthma. The MOST appropriate ALTERNATIVE topical glaucoma therapy with a similar IOP-lowering efficacy but without systemic beta-blockade is:
- A Betaxolol 0.5%
- B Latanoprost 0.005% ✓
- C Brimonidine 0.2%
- D Dorzolamide 2%
Correct answer: B. Latanoprost 0.005%
Explanation
Prostaglandin analogues (latanoprost, bimatoprost, travoprost) reduce IOP by 25–35% by increasing uveoscleral and trabecular outflow with no systemic beta-blockade. They are the current first-line agents for POAG. Betaxolol is a cardioselective beta-1 blocker that can still cause asthma and bradycardia in susceptible patients and should be used cautiously. Brimonidine (alpha-2 agonist) and dorzolamide (topical CA inhibitor) lower IOP less than prostaglandins and have their own systemic side-effect profiles.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.