A review of the pharmacology of carbonic anhydrase inhibitors for the treatment of glaucoma in dogs and cats

•Topical 2% dorzolamide is a safe and effective intraocular pressure (IOP) lowering agent in dogs and cats.•Dorzolamide can be used in the treatment of both primary and secondary glaucoma in dogs and cats.•Dorzolamide should be considered as the first-line therapy for feline glaucoma.•Topical carbonic anhydrase inhibitors (CAIs) do not cause systemic side effects, but can cause ocular side effects.•Systemic CAIs are also effective in lowering IOP, but their clinical application is limited by their systemic toxicity.

Glaucoma is a heterogeneous group of disorders usually associated with elevated intraocular pressure (IOP), leading to optic nerve damage, retinal ganglion cell death and irreversible vision loss. Therefore, medications that lower IOP are the mainstay of glaucoma therapy. Carbonic anhydrase inhibitors (CAIs) are some of the principal drugs used in the management of canine and feline glaucoma. This paper summarises current knowledge of the mechanism of action of these agents and their effect on IOP in dogs and cats. It also discusses potential harmful side effects of CAIs and presents current opinions about their role and place in the medical management of glaucoma in small animals.