Pharmaceutical ophthalmic compositions comprising active ingredient(s) such as carbonic anhydrase inhibitor (CAI) or combinations and processes for making such compositions and the use of these compositions in patient populations including pediatric populations. A process for preparing an ophthalmic composition comprising a carbonic anhydrase inhibitor, which comprises a) preparing a slurry comprising a carbonic anhydrase inhibitor and a surfactant b) preparing a polymer slurry comprising a polymer and water c) preparing a solution comprising tonicity and preservative agents d) mixing the polymer slurry of step b and the solution of step c, to form a vehicle concentrate and adjusting pH e) adding the slurry of step a, to the vehicle concentrate of step d and mixing to homogenize f) autoclaving the mixture of step e g) sizing the mixture of step f, under aseptic condition.
