What is a contraindication for prostaglandin analog therapy?

• A. Patients with dry eye
• B. Patients with significant inflammation
• C. Patients with high intraocular pressure
• D. Patients with a history of allergy to penicillin

Answer: (B)

Prostaglandin analogs lower intraocular pressure mainly by increasing aqueous humor outflow through the uveoscleral pathway, making them a common first-line treatment for POAG and ocular hypertension. A key safety concern is that they can provoke or worsen ocular inflammation. In eyes with significant inflammation (for example, active uveitis), using a prostaglandin analog can aggravate the inflammation and is contraindicated or used only with great caution. That’s why this option is the best answer.

Dry eye isn’t a contraindication; it’s a common comorbidity or side effect and can be managed. High intraocular pressure is precisely what these drugs aim to lower, not contraindicate. A history of penicillin allergy is unrelated to the mechanism or safety profile of prostaglandin analogs.