Abstract

To prevent loss of peripheral vision in chronic glaucoma uninterrupted control of intra-ocular pressure is important, and we have discussed the use of local applications for this.¹ A carbonic anhydrase inhibitor given by mouth may be a useful adjunct to treatment when intra-ocular pressure cannot be controlled by local applications alone or by operations such as cutting a drainage channel from the anterior chamber to the subconjunctival tissue. Carbonic anhydrase inhibitors may also usefully reduce tension for a short time in acute closed angle glaucoma (where the drainage angle of the anterior chamber is blocked), in acute glaucoma due to uveitis (the commonest cause of secondary glaucoma) and before operations for glaucoma. Their use is dangerous if they mask symptoms and so delay surgery; and thus for eye conditions carbonic anhydrase inhibitors are best given only on the advice of an ophthalmologist. The value of certain minor operations (e.g. trabeculotomy) which may increase the responsiveness of the eye to drugs is being investigated.