Part 3 of 14 of “Adjusting the Faucet or Opening the Drain – Currently Available Methods to Treat the Plumbing Problem of Open Angle Glaucoma” | A San Gabriel Valley Optometric Society (SGVOS) Continuing Education Dinner Event – 2 hours CE | Featured Speaker: Dr. David Richardson, MD | April 12, 2017
They open the drain but not through the regular drain. they work quite well but they do have some conjunctival hyperemia almost always bothersome, and it only happens in the pigmented areas if you’ve got somebody that’s got blue lash growth most people appreciate that although under this slit lamp to provide more of **** spidery, and men don’t always appreciate it but
The prostaglandin associated periorbitopathy (that’s of the tissue around the eye now early on you’ve got somebody with some excess bags seem to tighten up a little bit like they’ve that’s great early on but if it progresses much that it’s difficult to obtain a pressure so this can actually get in the way of your ability to monitor glaucoma. this is controversial
But the prostaglandins so it makes perfect sense that they are pro-inflammatory increase the risk of macular edema at least for macular edema, herpes virus reactivation use this particular drop to lower the pressure infection at least of the eye, and then headaches— pilocarpine that’s the one thing we all now these are still around because they can with narrow angles
But there also still worth because they do work pretty well — they essentially they provide some tension on the but brow ache poor night vision due to the these other issues—retinal detachment more if you’ve got a retinal detachment and somebody and then less likely but something that was this class and also when we were using this pemphigoid, corneal endothelial
Toxicity, inhibitors that can give you issues with the fortunately we now have these fixed combination agents. + brimonidine, simbrinza® which is brimonidine + brinzolamide. now the other thing to keep in mind here is , the two that are fixed combination agents it’s a twice a day agent where you’re using timolol twice a day which really is you all that much in terms
Of the aqueous but the other thing is we now know that using patients at risk for what’s called dipping, by 10 points patients who dip are at a much, so why in the world would you want to use but then moves systemically in most patients at night? . well, dorzolamide and brimonidine both work best three times a day. you’re not getting the right dosing on the getting
Too much timolol and potentially actually most internists are happy to do it because for that reason i’ve really moved to simbrinza® the patients don’t get that middle of the so those are the drops.
Transcribed from video
Prostaglandin Analogs, Cholinergic Receptors Agonists, Fixed Combination Agents By San Marino Eye | David D. Richardson MD Inc.