The ophthalmic drug that can cause discomfort in the brow area is:

• A. Timolol
• B. Latanoprost
• C. Dorzolamide
• D. Pilocarpine

Answer: (D)

Pilocarpine can cause brow discomfort because it is a direct muscarinic (cholinergic) agonist that stimulates the iris sphincter and the ciliary muscle. This stimulation induces miosis and marked ciliary muscle contraction to improve aqueous humor outflow. The accompanying ciliary spasm and increased accommodation effort can produce pain or discomfort felt in the brow area after instillation.

Other glaucoma meds have different typical side effects—timolol is a beta-blocker with systemic or local ocular surface effects, latanoprost often causes conjunctival redness and eyelash changes, and dorzolamide may cause a bitter taste or transient blurred vision—so brow discomfort is most characteristic of pilocarpine.