Epinephrine and other sympathomimetic amines have been used in the treatment of various forms of glaucoma for at least 30 years. Within the last 4 years uniform and reasonably stable preparations of racemic epinephrine bitartrate and l-epinephrine hydrochloride have become available widely for clinical use.
When tonography was performed on patients in whom the intraocular pressure (IOP) had been lowered by the addition of one of these preparations to the therapeutic program, in the first few weeks the lowering of the pressure was in most cases the result of a reduction in the rate of production of aqueous humor. This effect has been described most recently by Becker and Ley.
When the epinephrine treatment was continued for a period of weeks or months, a different effect was observed in that the pressure remained low and the facility of outflow ("C") became larger. In a majority of the patients so treated,
BALLINTINE EJ, GARNER LL. Improvement of the Coefficient of Outflow in Glaucomatous Eyes: Prolonged Local Treatment with Epinephrine. Arch Ophthalmol. 1961;66(3):314–317. doi:10.1001/archopht.1961.00960010316004
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