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Angle Closure Glaucoma: Treatment

Angle Closure Glaucoma: Treatment

Angle-closure glaucoma, or closed-angle glaucoma, is an eye condition where the iris bulges out and blocks the iridocorneal angle, resulting in a buildup of aqueous humor and increased intraocular pressure. Immediate medical attention is necessary due to the sudden onset of symptoms. The treatment for angle-closure glaucoma includes short-term and long-term approaches. Short-term treatment involves using eye drops like pilocarpine to lower intraocular pressure by increasing aqueous humor...

Open Angle Glaucoma: Treatment

Open Angle Glaucoma: Treatment

In open-angle glaucoma, the iridocorneal angle remains open, but the trabecular meshwork becomes stiff, slowing down the outflow of aqueous humor. This causes a buildup of aqueous humor in the anterior chamber, leading to a sudden increase in intraocular pressure. The treatment for open-angle glaucoma focuses on reducing the elevated intraocular pressure by either decreasing the secretion of aqueous humor or increasing its outflow.
Drugs such as carbonic anhydrase inhibitors, α2- and...

Glaucoma: Overview

Glaucoma: Overview

Glaucoma is an eye condition characterized by increased intraocular pressure that damages the retina and optic nerve, leading to irreversible blindness if left untreated. The human eye has various components, including the cornea, iris, pupil, lens, and optic nerve. Aqueous humor is secreted by the epithelium of the ciliary body in the posterior chamber and flows through the trabecular meshwork and canal of Schlemm, maintaining normal intraocular pressure. The trabecular meshwork and the canal...

Cholinergic Antagonists: Pharmacokinetics

Cholinergic Antagonists: Pharmacokinetics

Cholinergic antagonists—such as antimuscarinics—are available in oral, topical, ocular, parenteral, and inhalational formulations. Most antimuscarinics are oral formulations, while scopolamine is available as a topical patch, and ipratropium and tiotropium are available as inhalation aerosols or powders. Atropine, tropicamide, and cyclopentolate are topically instilled in the eye. Most antimuscarinics are lipid-soluble and readily absorbed from the gastrointestinal tract and the conjunctiva.

Ophthalmic Drug Delivery Systems

Ophthalmic Drug Delivery Systems

Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

Direct-Acting Cholinergic Agonists: Therapeutic Uses

Direct-Acting Cholinergic Agonists: Therapeutic Uses

Direct-acting cholinergic agonists have many therapeutic uses in various medical fields. Choline esters, including acetylcholine, have limited clinical utility due to their non-selectivity and short duration of action. Still, acetylcholine and carbachol are applied topically during ophthalmologic surgery to induce miosis. Pilocarpine, a muscarinic and ganglionic stimulator, effectively treats open-angle glaucoma and alleviates xerostomia and dry mouth caused by radiotherapy or Sjögren syndrome.

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Related Experiment Videos

Acute angle-closure glaucoma precipitated by local tiotropium absorption.

H Oksuz¹, C Tamer, S Akoglu

¹Department of Ophthalmology, Mustafa Kemal University, Medical Faculty, 31100 Hatay, Turkey. huseyinoksuz1@yahoo.com

Pulmonary Pharmacology & Therapeutics

|September 29, 2006

Summary

Acute angle-closure glaucoma, a rare condition, can be triggered by pupillary dilation. This case report explores a potential link between topical tiotropium absorption and acute angle-closure glaucoma attacks in susceptible individuals.

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Area of Science:

Ophthalmology
Pharmacology

Background:

Acute angle-closure glaucoma (AACG) is an ophthalmic emergency.
It occurs when aqueous humor outflow is obstructed, leading to increased intraocular pressure.
Pupillary dilation is a known precipitating factor in predisposed eyes.

Observation:

This case report details a patient experiencing an acute angle-closure glaucoma attack.
The patient had received local tiotropium treatment.

Findings:

A potential association between topical tiotropium absorption and the precipitation of an acute angle-closure glaucoma attack is investigated.
The mechanism may involve tiotropium-induced pupillary dilation in a susceptible individual.

Implications:

Clinicians should consider the potential risk of AACG with topical tiotropium use in predisposed patients.
Further research may be warranted to elucidate this association and inform clinical practice.
This highlights the importance of careful medication review in glaucoma management.