Which class of anti-glaucoma medication works by increasing aqueous outflow through the uveoscleral (non-trabecular) pathway?

• A Beta-adrenergic blockers (timolol)
• B Carbonic anhydrase inhibitors (dorzolamide)
• C Alpha-2 agonists (brimonidine)
• D Prostaglandin analogues (latanoprost, bimatoprost) ✓

Explanation

Prostaglandin analogues (latanoprost, travoprost, bimatoprost, tafluprost) are the most potent IOP-lowering agents, reducing IOP by 25–35%. Their primary mechanism is increasing uveoscleral (suprachoroidal/unconventional) outflow by remodeling ciliary muscle extracellular matrix and relaxing smooth muscle, allowing aqueous to flow around the ciliary body into the supraciliary and suprachoroidal spaces. Beta-blockers and CAIs reduce aqueous production; alpha-2 agonists both reduce production and marginally increase uveoscleral outflow.

Reference: Khurana Comprehensive Ophthalmology, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.