Direct- acting | Pilocarpine 0.5-4% Carbachol 0.75-3% | Facilitates aqueous out?ow by contraction of the ciliary muscle, tension on the scleral spur and traction on the trabecular meshwork | 20-25% | Post-operative inflammation, uveitis neovascular glaucoma. Patient at risk for retinal detachment, spastic gastrointestinal disturbances, peptic ulcer, pronounced bradycardia, hypotension, recent myocardial infarction, epilepsy, Parkinsonism | Local: Reduced vision due to miosisand accommodative myopia, conjunctival, hyperaemia, retinal detachment, lens opacities, precipitation of angle closure, iris cysts Systemic: Intestinal cramps, bronchospasm, headache |
Indirect- acting | Demecarium bromide 0.125-0.25% Ecothiophate iodide 0.03% Diisopropyl ?uorophosphates 0.025-0.1% | | 15-25% | Same as direct acting drugs | Local and systemic: Side effects are similar but more pronounced than with direct acting compounds |