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Related Experiment Videos

Dilating dangerous pupils.

R Mapstone

    The British Journal of Ophthalmology
    |August 1, 1977
    PubMed
    Summary
    This summary is machine-generated.

    Cyclopentolate and tropicamide eye drops can trigger angle-closure glaucoma in at-risk patients. Phenylephrine with thymoxamine is the safest dilation method for glaucoma patients.

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    Area of Science:

    • Ophthalmology
    • Pharmacology

    Background:

    • Closed-angle glaucoma poses a risk during ocular examinations requiring pupil dilation.
    • Mydriatic agents are commonly used but can precipitate angle closure in susceptible individuals.

    Purpose of the Study:

    • To evaluate the safety and efficacy of different mydriatic agents in patients at risk for closed-angle glaucoma.
    • To determine the safest pharmacological approach for pupil dilation in high-risk glaucoma patients.

    Main Methods:

    • 85 eyes at risk for closed-angle glaucoma were dilated using parasympatholytic or sympathomimetic drugs.
    • Comparison of pupil dilation effects with cyclopentolate, tropicamide, and phenylephrine.
    • Provocative testing with pilocarpine and phenylephrine was performed.

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    Main Results:

    • Cyclopentolate (1/2%) caused angle closure and elevated pressure in 9 of 21 eyes.
    • Tropicamide (1/2%) induced angle closure and elevated pressure in 19 of 58 eyes.
    • Phenylephrine alone was safe for dilation; subsequent pilocarpine miosis caused angle closure in all tested eyes.

    Conclusions:

    • Cyclopentolate is contraindicated for dilating eyes at risk of closed-angle glaucoma.
    • Tropicamide can be used with precautions, but phenylephrine-induced mydriasis followed by thymoxamine miosis is the safest method.