A 61-year-old man is noticed to have increased intraocular pressure on a routine eye examination. The visual acuity is normal in both eyes. The dilated eye examination reveals no evidence of optic nerve damage. Visual field testing shows mild loss of peripheral vision. He is diagnosed with primary open-angle glaucoma and is started on pilocarpine ophthalmic drops.

2.  A 61-year-old man is noticed to have
increased intraocular pressure on a routine
eye examination. The visual acuity is normal
in both eyes. The dilated eye examination
reveals no evidence of optic nerve damage.
Visual field testing shows mild loss of
peripheral vision. He is diagnosed with
primary open-angle glaucoma and is started
on pilocarpine ophthalmic drops.

3. Questions
1. What is the action of pilocarpine on the
muscles of the iris and cilia?
2. What receptor mediates this action?
3. Is pilocarpine the appropriate first-line drug
for the treatment of primary open-angle
glaucoma?

4. Summary
 A 61-year old man with open-angle glaucoma
is prescribed pilocarpine ophthalmic drops

5. Action of pilocarpine on muscles of
the iris and cilia
Constriction of the muscles

6. Receptor that mediates this action
Muscarinic cholinoreceptor

7. First line drugs to treat primary
open-angle glaucoma
Prostaglandin analogs