A 20-year-old man with sickle cell disease presents with a 25% traumatic hyphema and IOP of 32 mmHg. Which class of drug should be AVOIDED in lowering his pressure?
- A Systemic carbonic anhydrase inhibitors ✓
- B Topical alpha-2 agonists
- C Topical beta-blockers
- D Hyperosmotic agents
Correct answer: A. Systemic carbonic anhydrase inhibitors
Explanation
Carbonic anhydrase inhibitors such as acetazolamide acidify the aqueous humour and systemic blood, promoting sickling of red cells in the anterior chamber and trabecular meshwork, which worsens outflow obstruction in sickle cell patients. Methazolamide is a less sickling-prone alternative if needed. Beta-blockers, alpha-2 agonists, and hyperosmotics lower pressure without altering aqueous pH and are safe choices in this setting.
Reference: American Academy of Ophthalmology BCSC, Glaucoma Section, 2023-2024 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.