Abstract: Brimonidine tartrate, a third-generation alpha-2 adrenergic receptor agonist, is widely used in the treatment of glaucoma and ocular hypertension. It lowers intraocular pressure (IOP) by reducing aqueous humor production and increasing uveoscleral outflow. Beyond its IOP-lowering effects, growing evidence suggests that brimonidine may also provide neuroprotection through IOP-independent mechanisms, such as enhancing retinal ganglion cell survival or inducing the expression of neuronal survival factors. Additionally, brimonidine induces miosis by activating presynaptic alpha-2 receptors, which reduces norepinephrine release, leading to relaxation of the iris dilator muscle and relative dominance of the sphincter muscle. This miotic effect offers clinical benefits in improving nighttime visual quality for patients following laser corneal refractive surgery and intraocular lens implantation.

Key words: Brimonidine tartrate, Intraocular pressure reduction, Miosis, Neuroprotection