Topical carbonic anhydrase inhibitors (CAIs) such as brinzolamide 1% (Azopt; Alcon Laboratories, Fort Worth, TX, USA) attenuate bicarbonate efflux, and this may lead to corneal oedema.

To our knowledge, this is the first report of complete resolution of corneal oedema after cessation of topical brinzolamide 1%.

CASE REPORTS

A 57 year old African-American man with primary open angle glaucoma (POAG) presented with painless blurry vision left eye 1 hour after instilling brinzolamide 1% in both eyes. He had been on brinzolamide 1% both eyes twice daily, brimonidine tartrate 0.2% (Alphagan) in both eyes twice daily, and latanoprost 0.005% (Xalatan) in both eyes once at night for 2 years. On presentation, best corrected visual acuity (BCVA) was 20/25 right eye and 20/50 left eye. The left eye had mild corneal oedema, Descemet’s folds, and whitish fleck-like debris on the corneal endothelium (fig 1A). Intraocular pressures (IOPs) were …