for the treatment of systemic hypertension. They are less effective, but are not necessarily ineffective, in blacks.

Several components of the renin-angiotensin system have been identified in the eye. Oral administration of 25 mg of the ACE inhibitor captopril significantly lowered IOP in patients with normal IOP and primary open-angle glaucoma.43 Topical ACE inhibitors have also been shown to lower IOP in humans.44 Outflow facility, measured by tonography, increased significantly after oral administration of captopril,43 although this drug has other effects on aqueous dynamics.

9.1.5 Other Hypertensive Medications. Dopamine agonists and antagonists, which can affect blood pressure, can lower IOP in humans.45

Several hypertensive agents may increase IOP by causing lens swelling and angle-closure glaucoma in patients with narrow anterior chamber angles. Diuretics that may cause angle-closure glaucoma include thiazides and related drugs (chlorothiazide, chlorthalidone, hydrochlorothiazide, polythiazide, and trichlormethiazide)

and potassium-sparing diuretics (spironolactone).46 The direct vasodilator hydralazine has also been found to cause idiopathic swelling of the lens and angle-closure glaucoma.46

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