Which drug decreases production of aqueous humor?

• A. Diamox
• B. Mannitol
• C. Atropine
• D. Latanoprost

Answer: (A)

Decreasing production of aqueous humor lowers intraocular pressure by cutting the fluid’s formation at the ciliary processes. Diamox, or acetazolamide, is a carbonic anhydrase inhibitor that acts in the ciliary body to reduce bicarbonate formation. With less bicarbonate available, ion transport and fluid secretion into the aqueous humor decline, so production drops and IOP falls.

Mannitol lowers intraocular pressure through an osmotic effect that draws fluid out of the eye, not by decreasing production. Atropine, an anticholinergic, dilates the pupil and can raise intraocular pressure in susceptible eyes. Latanoprost increases outflow of aqueous humor via the uveoscleral pathway, rather than reducing its production.