Which ocular history would you be most concerned about when initiating a short-acting beta-2 agonist such as albuterol?

• A. History of POAG
• B. History of Cataracts
• C. History of Uveitis
• D. History of AMD

Answer: (A)

The key idea here is how beta-adrenergic stimulation can affect the eye’s fluid dynamics. Activating beta receptors in the ciliary body increases production of aqueous humor. In someone with glaucoma, where drainage of that fluid is already impaired, any additional increase in production can raise intraocular pressure and risk further optic nerve damage. So a history of primary open-angle glaucoma means starting a short-acting beta-2 agonist like albuterol could worsen their condition, making it the most concerning ocular history.

The other choices don’t directly involve changes in intraocular pressure. Cataracts and age-related macular degeneration affect the lens or macula, not aqueous humor dynamics. Uveitis is inflammatory and not primarily about pressure changes caused by adrenergic stimulation, so it’s less directly relevant to this medication.