title: A paradoxical ocular effect of brimonidine.
abstract: OBJECTIVE
  We report an unusual paradoxical effect of brimonidine.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 70-year-old woman with bilateral normal tension glaucoma was treated with topical brimonidine and followed in an outpatient setting. The main outcome measured was intraocular pressure (IOP) in mm Hg.
  
  
  RESULTS
  Brimonidine was observed to cause IOP elevation, confirmed on rechallenge, scoring 8 (strong probability) on an adverse drug reaction probability score.
  
  
  CONCLUSIONS
  Under certain circumstances topical brimonidine can cause paradoxical raised IOP necessitating vigilance in follow-up of patients on topical brimonidine.
authors.affiliation: Birmingham and Midland Eye Centre, Birmingham University Hospital Selly Oak, United Kingdom.
authors.forename: Bushra
authors.initials: B
authors.lastname: Mushtaq
authors.forename: Jagadish
authors.initials: J
authors.lastname: Sardar
authors.forename: Tim D
authors.initials: TD
authors.lastname: Matthews
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000009:adverse effects*; D000368:Aged; D000068438:Brimonidine Tartrate; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D009798:Ocular Hypertension / Q000139:chemically induced*; D011810:Quinoxalines / Q000009:adverse effects*
chemical_list: D000316:Adrenergic alpha-Agonists; D011810:Quinoxalines; D000068438:Brimonidine Tartrate