A patient with traumatic hyphema and intraocular pressure of 30 mmHg is also found to have sickle cell trait. Which systemic agent should be AVOIDED in lowering his pressure?

• A Topical timolol
• B Topical latanoprost
• C Topical apraclonidine
• D Systemic acetazolamide ✓

Explanation

Acetazolamide is avoided in sickle cell haemoglobinopathy because it increases aqueous ascorbate, acidifies the anterior chamber, promotes sickling of erythrocytes in the trabecular meshwork, and raises systemic plasma osmolality, all worsening outflow obstruction. Topical beta blockers and alpha agonists do not alter red cell sickling behaviour, which removes them from consideration.

Reference: American Academy of Ophthalmology, BCSC Section 10: Glaucoma, 2022-2023 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.