Lens, Glaucoma, and the Fundus Practice Test

Hyperosmotic diuretics lower intraocular pressure by raising plasma osmolality, which pulls water out of ocular tissues and reduces vitreous volume quickly. Isosorbide is an oral hyperosmotic agent that increases blood osmolality and draws fluid from the eye, producing a rapid drop in intraocular pressure—this makes it a clear example of a hyperosmotic diuretic used in glaucoma management. Mannitol and glycerin are also hyperosmotic options, but acetazolamide lowers IOP by decreasing aqueous humor production through carbonic anhydrase inhibition, not by creating an osmotic gradient.