What are side effects of prostaglandin analogs?

• A. Topical irritation and exacerbation of uveitis
• B. Miosis
• C. Systemic hypotension
• D. No adverse effects

Answer: (A)

Prostaglandin analogs lower eye pressure by increasing outflow of aqueous humor through the uveoscleral pathway. Because their action involves prostaglandins in the eye, they often provoke local inflammatory-type responses on the ocular surface. The most common adverse effects you’ll hear about are topical irritation—burning, stinging, dryness—and conjunctival redness. In people with inflammatory eye conditions, these drugs can also potentially worsen inflammation, so a flare of uveitis is a plausible adverse effect in susceptible individuals.

Miosis isn’t a typical consequence of these meds; they don’t usually constrict the pupil. Systemic hypotension is unlikely with topical therapy due to limited systemic absorption. And there are well-established local adverse effects, so saying there are no adverse effects isn’t accurate.