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April 1991

Glaucoma Treatment and Pregnancy-Reply

Arch Ophthalmol. 1991;109(4):463. doi:10.1001/archopht.1991.01080040023003

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In Reply  —I am not quite sure what point Dr Flach was making. Of the two sentences he quotes, he says, "This is not correct." However, as Dr Flach points out, carbonic anhydrase inhibitors are unquestionably teratogenic in certain animals. Thus, at least the final portion of the first sentence is correct. To my knowledge, the second sentence is also correct, since I know of no evidence to indicate that miotics, sympathomimetics, and β-blockers cause abnormalities in the doses used in ophthalmology. The studies by Landauer and Jost and colleagues, cited by Flach, employed vastly larger doses, such as direct injection of epinephrine into a rabbit fetus. I may have overlooked information showing that miotics, sympathomimetics, and β-blockers are teratogenic in the doses used in ophthalmology. If I have, I would be grateful to be given the information so that I could make more accurate statements in the future. I

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