TOPLINE:

Men with benign prostatic hyperplasia (BPH) who took alpha-blockers to manage the condition were roughly 50% more likely to develop acute angle-closure glaucoma than were those who did not use the medication, and the incidence increased with longer exposure to the drugs.

METHODOLOGY:

• Researchers investigated whether the use of alpha-blockers for BPH was associated with the incidence of acute angle-closure glaucoma.
• They used a Korean database to review insurance claims and health records from 2002 to 2022 and identified men with BPH prescribed alpha-blockers.
• Patients were categorized into three groups based on the duration of exposure to alpha-blockers: 23 days or less, 24-202 days, and 203 days or more.
• Researchers identified patients who developed acute angle-closure glaucoma while using alpha-blockers and propensity score-matched them to those who did not develop the condition.

TAKEAWAY:

• The final analysis included 30,450 patients. Of them, 5075 (mean age, 56.3 years) developed acute angle-closure glaucoma while using alpha-blockers, and 25,375 did not develop the condition.
• Men who used alpha-blockers had a 52% higher risk for developing acute angle-closure glaucoma than did those who did not take the drugs (adjusted hazard ratio, 1.52; P < .001).
• The incidence rate of acute angle-closure glaucoma increased with longer exposure to alpha-blockers: 0.15% for exposure of 23 days or less, 0.20% for exposure of 24-202 days, 0.41% for exposure of 203 days or more.

IN PRACTICE:

“Because [alpha]-blockers are essential for managing urinary symptoms, discontinuation may not always be feasible. For patients at high risk of [acute angle-closure glaucoma], such as those with narrow anterior chamber angles, prescribing [alpha]-blockers should involve careful counseling, individualized risk assessment, and close monitoring,” the researchers wrote.

“In such cases, alternative therapies, including 5-[alpha] reductase inhibitors or phosphodiesterase-5 inhibitors, may be considered safer options,” they added.

SOURCE:

This study was led by Sung Uk Baek, MD, PhD, of the Hallym University Sacred Heart Hospital in Anyang, and Su Hwan Kim, PhD, of the Gyeongsang National University in Jinju-si, both in South Korea. It was published online on November 12, 2025, in American Journal of Ophthalmology.

LIMITATIONS:

Acute angle-closure glaucoma was identified from claims data, which limited diagnostic verification. Benign prostatic hyperplasia is associated with older age, often accompanied by other conditions that could independently raise the risk for acute angle-closure glaucoma. Individual alpha-blocker drugs were not compared. 

DISCLOSURES:

This study did not receive any specific funding. The authors declared having no conflicts of interest. 

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.