Atlas of Ophthalmology

Conjunctival hyperemia, bilateral secondary to prostaglandin analog use for glaucoma

Conjunctival hyperemia, bilateral secondary to prostaglandin analog use for glaucoma
Prostaglandin analogs can be used for the treatment of open-angle glaucoma through the reduction of intraocular pressure. Prostaglandins reduce the intraocular pressure by increasing the outflow of aqueous fluid from the eye. By reducing intraocular pressure, they suppress the effects of glaucoma. Prostaglandins are administered through eye drop solution. A side effect of prostaglandin use is the development of conjunctival hyperemia. Hyperemia is a condition in which there is an increase in blood flow to a specific part of the body, in this case, the sclera of the eye. However, conjunctival hyperemia may be associated with wide range of ocular diseases, and can also be a response to allergic inflammation or irritation. Therefore, it is important that a physician distinguish the underlying disorder before altering medication. The incidence of hyperemia varies with the drug being utilized. Latanaprost has exhibited an incidence of 5%-15%1, bimatoprost at 15%-45%2, and travoprost at 35%-50%3. It is believed that prostaglandins cause the aqueous to utilize ocular circulation, resulting in the vasodilation observed. It is important to note that these side effects often manifest at the beginning of treatment and usually return to baseline levels after a few weeks. This is most likely due to adaptation to the drug. Therefore, patients who have had previous exposure to prostaglandins will probably respond with less hyperemia if another drug is prescribed. Some of the other side effects of prostaglandins include blurred vision, a decrease in visual acuity, dry eyes, inflammation in the anterior chamber of the eye, and skin rash or allergic skin reaction. Itching, burning, and stinging during administration of the drug is also a common side effect. Other less common side effects are cystoid macular edema, overgrowth of eyelashes, darkening of eyelid skin color, and darkening of iris color. This patient was switched to another brand of prostaglandin glaucoma drops because after several months, his conjunctival hyperemia would not improve. This patient has primary open angle glaucoma, the number one type of glaucoma in African-Americans. 1. Xalatan Package Insert. Kalamazoo, Mich: Pharmacia; 2000. 2. Lumigan Package Insert. Irvine, Calif: Allergan Inc; 2001. 3. Travatan Package Insert. Fort Worth, T. Alcon Pharmaceuticals. 2001.
Khan M, Mohammad, , Binghampton University, New York, USA; Luviano, Damien, M.D., SETMA, Beaumont, USA
Conjuntiva -> Hyperemia
eye, redness, pink, irritation, irritated, compliance, discontinue, medications
Copyright @ Online Journal of Ophthalmology

-------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- -------------------------- --------------------------