The carbonic anhydrase inhibitors are the drugs most useful clinically in reducing aqueous flow and lowering intraocular pressure.1-3 Their hypotensive effect is greater in the hypertensive eye than in the normal, and in the latter has been reported to be accompanied by a compensatory reduction in outflow facility.3,4 Mechanisms other than a reduction in aqueous flow have been postulated for these agents, but have received little support.5,6 No studies have come to our attention indicating that these agents might primarily influence outflow facility.
This communication reports a small series of patients in whom significant, reproducible improvement in outflow facility and reduction in intraocular pressure resulted after therapy with acetazolamide alone. No effect on aqueous flow was discernible. Because of the significant improvement in outflow facility unobtainable by any other form of therapy, all these patients have been maintained solely on treatment with this compound for more than
GALIN MA, HARRIS L. Acetazolamide and Outflow Facility. Arch Ophthalmol. 1966;76(4):493-497. doi:10.1001/archopht.1966.03850010495006