Intraocular pressure elevation after pupillary dilation in open angle glaucoma
B. R. Shaw and R. A. Lewis
Acute elevation of intraocular pressure frequently follows pupillary
dilation in patients with primary open angle glaucoma. A retrospective
study of 60 patients (116 eyes) with primary open angle glaucoma was done
to assess the frequency and severity of intraocular pressure elevation
following dilation with 2.5% phenylephrine hydrochloride (Neo-Synephrine)
and 1% tropicamide (Mydriacyl). Significant pressure elevation (greater
than 5 mm Hg) occurred in 37 eyes (32%). Marked pressure elevation (greater
than 10 mm Hg) occurred in 14 eyes (12%). The only significant risk factor
found was treatment with miotics. The change of intraocular pressure one
hour after dilation was compared with the one-hour postoperative change in
intraocular pressure in those patients (12 patients, 18 eyes) who
subsequently underwent argon laser trabeculoplasty. No statistically
significant correlation was found. There is a potential hazard of routine
dilation of eyes with open angle glaucoma.
