A 68-year-old woman with advanced Fuchs endothelial corneal dystrophy and newly diagnosed open-angle glaucoma needs additional medical therapy. Topical dorzolamide should be avoided in her chiefly because it:
- A Raises intraocular pressure in corneal guttata
- B Induces irreversible mydriasis through sphincter paralysis
- C Impairs corneal endothelial pump function and can cause corneal decompensation ✓
- D Accelerates cataract formation in pseudophakic eyes
Correct answer: C. Impairs corneal endothelial pump function and can cause corneal decompensation
Explanation
Dorzolamide accumulates in corneal tissue and inhibits carbonic anhydrase within the endothelium, reducing endothelial bicarbonate transport and pump function. In compromised corneas such as Fuchs dystrophy or prior corneal edema, this can cause reversible corneal decompensation and thickening, so it is avoided. It does not raise pressure, affect pupil tone, or hasten cataract formation.
Reference: Katzung's Basic and Clinical Pharmacology, 15th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.