Carbonic anhydrase inhibition in glaucoma: hazard or benefit for the chronic lunger?

Carbonic anhydrase inhibitors, of proven value in the longterm management of glaucoma, have a number of troublesome side effects, most of which are well-known. However, their potential hazards to patients with chronic obstructive lung disease have received little attention. The author reviews the physiological effects of carbonic anhydrase inhibition on carbon dioxide metabolism and the implications for the chronic lung patient. The untoward pulmonary complications associated with the use of carbonic anhydrase inhibitors are of particular importance to ophthalmologists, since chronic lung disease and glaucoma, both common disorders in the elderly, frequently coexist in the same patient.