Category: transport
Intraocular pressure (IOP) reflects aqueous humor production (ciliary body) - outflow (trabecular meshwork + uveoscleral). Glaucoma Rx classes attack both arms. (1) Decrease production: β-blockers (timolol, betaxolol) — block ciliary β-receptors that drive aqueous secretion; α2-agonists (brimonidine, apraclonidine) — Gi-coupled inhibition of cAMP-driven production; carbonic anhydrase inhibitors (dorzolamide topical, acetazolamide systemic). (2) Increase outflow: prostaglandin F2α analogs (latanoprost, bimatoprost, travoprost, tafluprost) — uveoscleral outflow facilitation by remodeling extracellular matrix; rho-kinase inhibitors (netarsudil) — trabecular meshwork; cholinergic miotics (pilocarpine — older) — open trabecular meshwork via ciliary muscle contraction.