NBEO Part II Treatment and Management of Ocular Disease (TMOD) Practice Test

This set of symptoms points to the systemic effects of oral carbonic anhydrase inhibitors. When taken systemically, these drugs block carbonic anhydrase in the kidney, causing bicarbonate loss and a non‑anion gap metabolic acidosis. That bicarbonate loss can produce a metallic taste and tingling in the extremities (paresthesias) as the body responds to the acid–base disturbance. In the eye, lower bicarbonate levels in the aqueous humor and changes in ciliary body dynamics can lead to a forward shift of the lens-iris diaphragm, causing a transient myopic shift. Topical carbonic anhydrase inhibitors can cause taste disturbance but rarely produce the full metabolic acidosis and paresthesias seen with the oral form, and the other drug classes listed have different adverse effect profiles.