POAG education mentions that starting an eye drop once daily before bed can cause which effects?

• A. Irritation
• B. Iris darkening
• C. Growth of eyelashes
• D. All of the above

Answer: (D)

Prostaglandin analogs used for POAG, often given once daily at night, can cause a few characteristic ocular changes. Irritation or mild conjunctival redness and stinging around the time of instillation are common surface effects. Iris darkening occurs because these medications can increase melanin production in the iris stroma, leading to a gradual, usually permanent pigment change that is more noticeable in lighter irises. Growth or thickening of the eyelashes happens as prostaglandins influence hair follicles, producing longer, fuller lashes over weeks to months. Because each of these effects can occur with nightly dosing, the correct understanding is that all of these effects may be observed.