True or False: Oral CAIs are typically used for chronic therapy.

• A. True
• B. False
• C. Depends on patient
• D. Not enough data

Answer: (B)

Oral carbonic anhydrase inhibitors lower intraocular pressure by systemically inhibiting CA in the ciliary body, producing a rapid drop in aqueous production. This makes them useful for quick IOP reduction in acute situations or as a bridge before surgery. But they come with significant systemic side effects—metabolic acidosis, electrolyte imbalances, kidney stones, fatigue, GI upset, and potential sulfa-related reactions—and require monitoring, which makes them less suitable for long-term, chronic glaucoma management. For chronic therapy, topical carbonic anhydrase inhibitors or other frontline agents (like prostaglandin analogs, beta-blockers, or alpha agonists) are preferred due to better tolerability and safety over time. So the statement is not accurate in routine practice.