👁 Side Effects of Prostaglandin Analogues in Glaucoma
PG analogues are first-line agents for glaucoma with excellent IOP-lowering effect.
While systemic side effects are rare, some local cosmetic and ocular changes may occur.
📋 Common Adverse Effects
Side EffectDescriptionReversible
| Conjunctival hyperemia | Most common, tends to decrease over time | ✅ Yes |
| Iris pigmentation | Increased melanin in melanocytes | ❌ No |
| Eyelash length/thickening | Seen with bimatoprost (→ Latisse) | ✅ Yes |
| Periorbital pigmentation | Darkening of eyelid skin | ✅ Yes |
| Deepening of upper lid sulcus (DUES) | Fat atrophy, especially with bimatoprost/travoprost | ✅ Yes |
⚠ Other Possible Reactions
- Anterior uveitis
- Cystoid macular edema (CME)
- Corneal erosion
- HSV dendritic keratitis
- Possible uterine contraction (theoretical concern in pregnancy)
✅ Summary
- Most side effects are cosmetic and reversible
- Iris pigmentation is permanent
- PG drugs remain safe, effective, and widely used
📌 Don’t let fear of minor side effects outweigh proven treatment benefits
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