Effect of combined 1% cyclopentolate-10% phenylephrine eye drops on systemic blood pressure of glaucoma patients

Sixty-two patients with glaucoma had eye drops containing 1% cyclopentolate hydrochloride and 10% phenylephrine hydrochloride applied two or three times to one or usually both eyes to dilate their pupils as part of routine eye examinations. Systemic (brachial) blood pressure was monitored before and after drug application. Fifty of the patients had either no change in blood pressure or a decrease. Only two patients had a rise of 20 mm Hg or more in either systolic or diastolic blood pressure. In these two cases the increases were 34/4 and 22/20 mm Hg. Ten patients had an increase ranging from 10 to 20 mm Hg in either systolic or diastolic pressure. The results suggest that a clinically dangerous rise in systemic blood pressure from use of these drops is not common. However, to lessen the risk further, it seems advisable to use drops containing 10% phenylephrine only when lower concentrations are ineffective in dilating the pupils.