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 Dr. Herritt continues:
 Blindness is a very grave consequence.
 Protecting patients from blindness is
 considered so important that it justifies the
 use of toxic medicines and uncertain surgical
 procedures which in other contexts might be
 considered _unsafe m. In practicer physicians
 often provide glaucoma patier_s with dr_Aas_
 ' which have many serious adverse effects_ _/
 a. _/la/maco i o_ic_l TheraDie_
 _ At presents there are four families of prescriptive
 dr_/gs commonly used in the treatment of glaucoma. These include
 the miotics, epinephrine compounds, cer1:ain diuretics and topical
 beta-blocking drugs°
 With the exception of Timolol (commercially known as
 Timoptic) _ each of the drags used to treat glaucoma did not
 receive NDA approval by FDA prior to marketing. Dr. Richard
 North_ a former IND/NDA Clinical Review Officer for ophthalmic
 drugs in the Bureau of Drugs, Federal Food and Drug
 Administration, 438/ in discussing the drug Diamox _- commonly
 used in glaucoma treatments commented:
 Diamox is a diuretic ... that was the
 approved indication by FDA ® [ Diamox ] was
 grandfathered into being used as a pressure-
 reducing drug, purely because it was used
 outside the normal [FDA-approved] indication
 by ophthalmologists.
 Stilweil: How did . . . other drugs become
 accepted as glaucoma medicine_,?
 North: By use as prescribed by the treating
 physicians. It would be noted [by
 KiZ/ I_, at _I 9-z0.
 .....
 4_8/ Cross-examination of Dr. Richard North, Tr. 7-62.
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