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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Alpha agonists became available in the 1990s and are used today as third-line drugs, with prostanoids being first line and beta blockers being second line. These include various formulations of brimonidine (Alphagan, Alphagan-P).

Alpha agonists work to both decrease production of fluid and increase drainage. Alphagan P has a purite preservative that breaks down into natural tear components and may be more effective for people who have allergic reactions to preservatives in other eye drops. Brimonidine is currently available in a generic form.

Who should not use these medications:

• Persons allergic to alpha adrenergic agonists

Use: These drugs are given as eyedrops to the affected eye(s).

Side effects: These eye drops should not be used while wearing contact lenses. Local allergic reactions are common, characterized by redness of the eyes and itching of the eyes. Excessive tearing, eye pain, or lid crusting may occur. Burning, stinging, foreign body sensation (something in the eye), blurred vision, and itching have also been observed.

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