Peter A Netland

Hypertensive drugs are commonly prescribed medications that may affect intraocular pressure (IOP). Although not prescribed by physicians, alcohol and marijuana are frequently self-administered substances that may also affect IOP. This chapter is not intended as an exhaustive review of the effects of all systemically administered drugs on the eye, but instead focuses on drugs widely used in the general population that can influence IOP.

The potential effect of systemic drugs on IOP may be overlooked by ophthalmologists, which may lead to confusion in the diagnosis or management of glaucoma. Because IOP readings may be lowered in patients taking these drugs, patients with high-pressure glaucoma may be misdiagnosed as having low-tension glaucoma, or the diagnosis of glaucoma may be missed altogether. Certain systemic medications may alter the expected effect of a topical medical regimen, such as when topical beta blockers are added in patients already using systemic beta blockers. Intoxication with alcohol or recent addition of hypertensive medications may mask elevated IOP or may impede the clinician's assessment of the effect of glaucoma medications.

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