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Angle Closure Glaucoma Precipitated by Aerosolized Atropine

Angle Closure Glaucoma Precipitated by Aerosolized Atropine Abstract Angle closure glaucoma is an infrequent form of glaucoma occurring when the filtration mechanism for the aqueous humor is obstructed by apposition of the peripheral iris to the trabecular meshwork. Anatomic features associated with acute-angle closure include congenitally small anterior segments, increased lens thickness, and shallow anterior chamber depth. We present two patients who developed signs and symptoms of angle closure glaucoma after receiving aerosolized atropine for treatment of chronic obstructive pulmonary disease. We recommend that before instituting therapy with an inhaled anticholinergic agent, the patient should be questioned concerning prior history of angle closure glaucoma symptoms and signs and the anterior chamber depth should be examined using iris illumination. Patients having shallow anterior chambers, or possible prior angle closure glaucoma attacks, should be examined by an ophthalmologist before inhalant anticholinergic therapy. (Arch Intern Med. 1991;151:1658-1660) References 1. Kolker AE, Hetherington J. Becker-Shaffer's Diagnosis and Therapy of the Glaucomas . 5th ed. St Louis, Mo: Mosby—Year Book, Inc; 1983. 2. Willetts GS, Hopkins DJ. Systemic therapeutic agents and glaucoma . Practitioner . 1972;209:27-34. 3. Simmons RJ, Dallow RL. Primary angle-closure glaucoma . In: Duane TD, ed. Clinical Ophthalmology . New York, NY: Harper & Row Publishers Inc; 1984;3. 4. Alsbirk PH. Angle-closure glaucoma surveys in Greenland Eskimos . Can J Ophthalmol . 1973;8:260-264. 5. Lowe RF. Aetiology of the anatomical basis for primary angle-closure glaucoma . Br J Ophthalmol . 1970;54:161-169.Crossref 6. Greenstein SH, Abramson DH, Pitts WR. Systemic atropine and glaucoma . Bull N Y Acad Med . 1984;60:961-968. 7. Leopold IH, Comroe JH. Effect of intramuscular administration of morphine, atropine, scopolamine and neostigmine on the human eye . Arch Ophthalmol . 1940;40:285-290.Crossref 8. Mehra KS, Chandra P, Khare BB. Ocular manifestations of parental administration of scopolamine (hyoscine) . Br J Ophthalmol . 1965;49:557-558.Crossref 9. Schwartz H, Apt L. Mydriatic effect of anticholinergic drugs used during reversal of nondepolarizing muscle relaxants . Am J Ophthalmol . 1979;88:609-612. 10. Gartner S, Billet E. Acute glaucoma: as a complication of general surgery . Am J Ophthalmol . 1958;45:668-671. 11. Wang BC, Tannenbaum CS, Robertazzi RW. Acute glaucoma after general surgery . JAMA . 1961;177:108-110.Crossref 12. Fario DT, Bateman JB, Christensen RE. Acute angle-closure glaucoma associated with surgical anesthesia . Arch Ophthalmol . 1985;103:360-362.Crossref 13. Sugar HS. Management of angle-closure glaucoma . Ann Ophthalmol . 1974;6:517-525. 14. Kramer P, Ritch R. The treatment of acute angle-closure glaucoma revisited . Ann Ophthalmol . 1984;16:1101-1103. 15. Malani JT, Robinson GM, Seneviratne EL. Ipratropium bromide induced angle closure glaucoma . N Z Med J . 1982;95:749. 16. Packe GE, Cayton RM, Mashhoudi N. Nebulized ipratropium bromide and salbutamol causing angle closure glaucoma . Lancet . 1984;2:691.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Angle Closure Glaucoma Precipitated by Aerosolized Atropine

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Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1991.00400080140028
Publisher site
See Article on Publisher Site

Abstract

Abstract Angle closure glaucoma is an infrequent form of glaucoma occurring when the filtration mechanism for the aqueous humor is obstructed by apposition of the peripheral iris to the trabecular meshwork. Anatomic features associated with acute-angle closure include congenitally small anterior segments, increased lens thickness, and shallow anterior chamber depth. We present two patients who developed signs and symptoms of angle closure glaucoma after receiving aerosolized atropine for treatment of chronic obstructive pulmonary disease. We recommend that before instituting therapy with an inhaled anticholinergic agent, the patient should be questioned concerning prior history of angle closure glaucoma symptoms and signs and the anterior chamber depth should be examined using iris illumination. Patients having shallow anterior chambers, or possible prior angle closure glaucoma attacks, should be examined by an ophthalmologist before inhalant anticholinergic therapy. (Arch Intern Med. 1991;151:1658-1660) References 1. Kolker AE, Hetherington J. Becker-Shaffer's Diagnosis and Therapy of the Glaucomas . 5th ed. St Louis, Mo: Mosby—Year Book, Inc; 1983. 2. Willetts GS, Hopkins DJ. Systemic therapeutic agents and glaucoma . Practitioner . 1972;209:27-34. 3. Simmons RJ, Dallow RL. Primary angle-closure glaucoma . In: Duane TD, ed. Clinical Ophthalmology . New York, NY: Harper & Row Publishers Inc; 1984;3. 4. Alsbirk PH. Angle-closure glaucoma surveys in Greenland Eskimos . Can J Ophthalmol . 1973;8:260-264. 5. Lowe RF. Aetiology of the anatomical basis for primary angle-closure glaucoma . Br J Ophthalmol . 1970;54:161-169.Crossref 6. Greenstein SH, Abramson DH, Pitts WR. Systemic atropine and glaucoma . Bull N Y Acad Med . 1984;60:961-968. 7. Leopold IH, Comroe JH. Effect of intramuscular administration of morphine, atropine, scopolamine and neostigmine on the human eye . Arch Ophthalmol . 1940;40:285-290.Crossref 8. Mehra KS, Chandra P, Khare BB. Ocular manifestations of parental administration of scopolamine (hyoscine) . Br J Ophthalmol . 1965;49:557-558.Crossref 9. Schwartz H, Apt L. Mydriatic effect of anticholinergic drugs used during reversal of nondepolarizing muscle relaxants . Am J Ophthalmol . 1979;88:609-612. 10. Gartner S, Billet E. Acute glaucoma: as a complication of general surgery . Am J Ophthalmol . 1958;45:668-671. 11. Wang BC, Tannenbaum CS, Robertazzi RW. Acute glaucoma after general surgery . JAMA . 1961;177:108-110.Crossref 12. Fario DT, Bateman JB, Christensen RE. Acute angle-closure glaucoma associated with surgical anesthesia . Arch Ophthalmol . 1985;103:360-362.Crossref 13. Sugar HS. Management of angle-closure glaucoma . Ann Ophthalmol . 1974;6:517-525. 14. Kramer P, Ritch R. The treatment of acute angle-closure glaucoma revisited . Ann Ophthalmol . 1984;16:1101-1103. 15. Malani JT, Robinson GM, Seneviratne EL. Ipratropium bromide induced angle closure glaucoma . N Z Med J . 1982;95:749. 16. Packe GE, Cayton RM, Mashhoudi N. Nebulized ipratropium bromide and salbutamol causing angle closure glaucoma . Lancet . 1984;2:691.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Aug 1, 1991

References