Epinephrine as the initial therapy in selected cases of ocular hypertension.

The authors believe that the epinephrines should be employed as the initial therapy in both primary open angle glaucoma and, when treated, ocular hypertension. Unlike pilocarpine, epinephrine does not produce miosis and accommodative spasm. Because of longer experience with epinephrine than with costly timolol, its longterm effectiveness and side effects are better known. Although the side effects of epinephrine are usually not serious, they may be intolerable to the patient. However, allergic blepharoconjunctivitis may be ameliorated by concomitant hydroxymesterone therapy. The availability of dipivalyl epinephrine (DPE) may decidedly shift the balance of the treatment of ocular hypertension, when indicated, to an epinephrine compound.