Metabolic acidosis induced by acetazolamide

The carbonic anhydrase inhibitors that are used most frequently in ophthalmic practice are acetazolamide and methazolamide. They both are weak systemic diuretics and lower intraocular pressure ultimately by decreasing aqueous production. Unfortunately, they have a number of important side effects including the potentiation or exacerbation of metabolic acidosis. In some patients, this pH shift may be quite transient and temporary; whereas, in some patients with other maladies, the acidosis may be much more serious. The patient herein reported had chronic obstructive pulmonary disease and had had a nephrectomy. Close patient monitoring is advisable in these types of patients.