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 acceptance among ophthalmologists as safe and effective lOP-
 lowering agents°
 , o-,
 The conventionally_prescribed drugs for glaucoma can
 significantly reduce intraocular pressure° The myotic agents
 , (pilocarpine and phospholine iodine) generate a 20% reduction in
 _9
 XOp.44_/: Epinephrine causes a 20% reduction. 9_I/ The diuretics
 (carbonic anhydrase inhibitors, including Diamox) can reduce
 intraocular pressure by as much as 50%. _-_/ Finally, Timolol on
 average, reduces lOP between 20% and 25%o 4'4_/
 It is generally accepted that 20 millimeters of
 mercury or lower is a _safe w range of pressure. _/
 /_ In therapy, the physician attempts to lower the
 patient°s XOP_ If this cannot be achieved using any one of the
 available medications_ then these drugs are used in various
 _._ .... combinations until an adequate reduction in ocular tension is
 achieved. ,447/ Dz. Robert Hepler described the typical treatment
 r process as follows:
 _! Short-acting miotics are first prescribed,
 followed by epinephrinew carbonic anhydraee
 inhibitors and_ finally_ long-acting mioticso
 The order of progression is determined by the
 relative safety (i_e_ known side effects) of
 i'
 _u42L/ Cross=examination of Keith Green, PhoD., Tr. 9-92.
 44_ /_. at 9-98.
 ___/ /__. at 9-86.
 445/ _. at 9_77.
 446/ Cross-examination of Dro Richard North, Tr. 7-71o
 _7/ Ido at 7-72-73 _ Dr. North provides an illustration of
 how combinations of drugs are employed to reduce intraocular
 _:_.
 pressure.
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