Which substances are reported to decrease intraocular pressure (IOP)?

• A. Systemic beta-blockers
• B. Digoxin
• C. Alcohol
• D. All of the above

Answer: (D)

Drugs can alter intraocular pressure by changing how aqueous humor is produced or drained. Systemic beta-blockers curtail aqueous production at the ciliary body by blocking beta-adrenergic receptors, which reliably lowers IOP. Alcohol can transiently lower IOP as well, likely through dehydration and reduced aqueous formation, though this is a short-lived effect and not a therapeutic approach. Digoxin has been reported to decrease IOP in some situations, though the mechanism isn’t clear and it isn’t used for eye pressure management; the effect is less consistent but has been observed. Taken together, each of these substances has reports of lowering IOP, so the overall answer reflects that all of the above can be associated with decreased IOP.