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👁 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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