The mechanism of action of CAIs is the suppression of aqueous production by inhibiting the isoenzyme carbonic anhydrase II. Systemic side effects such as fatigue, malaise, and weight loss may prevent the use of oral agents in many patients. Since the introduction of topical CAIs dorzolamide and brinzolamide, side effects related to this class of medications have markedly diminished. Either agent can be administered either twice daily or three times daily; the efficacy is similar when comparing the two agents; however, brinzolamide may be better tolerated due to its more neutral pH compared to dorzolamide.

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