Which prostaglandin is considered to have the worst conjunctival hyperemia effects?

Bimatoprost, marketed as Lumigan, is known for its potential to cause more significant conjunctival hyperemia compared to other prostaglandins such as latanoprost, travoprost, or unoprostone. This is partly due to its chemical structure and pharmacologic properties, which can lead to increased blood flow to the conjunctiva, resulting in redness and irritation.

In clinical studies, bimatoprost has shown a higher incidence of conjunctival hyperemia among users, which can impact patient adherence to therapy due to discomfort or cosmetic concerns. While other prostaglandins may also cause conjunctival hyperemia, bimatoprost's association is notably more pronounced, making it the prostaglandin with the worst effects in this regard. Understanding this side effect is important for practitioners when choosing treatment options for glaucoma or ocular hypertension and counseling patients on expected outcomes.