Abstract Cycloplegic agents may cause elevation of intraocular pressure in certain eyes without angle closure. Significant pressure increments occur in treated and untreated open angle glaucoma patients but are rarely noted in normal patients. Roughly one third of miotic-treated patients with open angle glaucoma studied by the authors are cycloplegic responsive. In approximately 50% of these patients the response represents a competitive inhibition of the miotic by the cycloplegic. In the remainder, a direct effect on ciliary muscle is possible. References 1. Kronfeld, P.; McGarry, H.I.; and Smith, H.F.: The Effect of Mydriatics Upon the Intraocular Pressure in Primary Wide-Angle Glaucoma , Amer J Ophthal 26:245-252 ( (March) ) 1943. 2. Christensen, R.E., and Pearce, J.: Homatropine Hydrobromide , Arch Ophthal 70:376-380 ( (Sept) ) 1963.Crossref 3. Galin, M.A.: Mydriasis Provocative Test , Arch Ophthal 66:353-355 ( (Sept) ) 1961.Crossref 4. Harris, L.S.: Cycloplegic-Induced Intraocular Pressure Elevations , Arch Ophthal 79:242-246 ( (March) ) 1968.Crossref 5. Harris, L.S., and Galin, M.A.: Cycloplegic Provocative Testing, Arch Ophthal, to be published. 6. Schimek, R., and Lieberman, W.J.: The Influence of Cyclogyl and Neosynephrine on Tonographic Studies of Miotic Control in Open-Angle Glaucoma , Amer J Ophthal 51:781-784 ( (May) ) 1951. 7. Barany, E.H., and Christensen, R.E.: Cycloplegia and Outflow Resistance , Arch Ophthal 77:757-760 ( (June) ) 1967.Crossref 8. Fortin, E.P.: Action du muscle ciliaire sur la circulation de l'oeil , C R Soc Biol 102:432-434 ( (Nov 4) ) 1929. 9. Armaly, M.F.: Studies on the Intraocular Effect of the Orbital Parasympathetic Pathway: I. Technique and Effects on Morphology , Arch Ophthal 61:14-29 ( (Jan) ) 1959.Crossref 10. Armaly, M.F.: Studies on the Intraocular Effect of the Orbital Parasympathetic Pathway: II. Effect on Intraocular Pressure , Arch Ophthal 62:117-124 ( (July) ) 1959.Crossref 11. Armaly, M.F.: Studies on the Intraocular Effect of the Orbital Parasympathetic Pathway: III. Effect on Steady-State Dynamics , Arch Ophthal 62:817-827 ( (Nov) ) 1958.Crossref 12. Armaly, M.F., and Burian, H.M.: Changes in the Tonogram During Accommodation , Arch Ophthal 60:60-69 ( (July) ) 1958.Crossref 13. Barany, E.H.: The Mode of Action of Pilocarpine on Outflow-Resistance in the Eye of a Primate , Invest Ophthal 1:712-727 ( (Dec) ) 1962. 14. Tornquist, G.: Comparative Studies of the Effect of Pilocarpine on the Pupil and on the Refractions on Two Species of Monkey , Invest Ophthal 3:388-398 ( (Aug) ) 1964. 15. Tornquist, G.: Effect on Refraction of Intramuscular Pilocarpine in Two Species of Monkey , Invest Ophthal 4:211-215 ( (April) ) 1965. 16. Barany, E.H.: " Dissociation of Accommodation Effects From Outflow Effects of Pilocarpine ," in Paterson, G. (ed.): Drug Mechanisms in Glaucoma , Boston: Little, Brown & Co., 1966, p 276.
Archives of Ophthalmology – American Medical Association
Published: Apr 1, 1969