Mydriatic angle-closure glaucoma--mechanism, evaluation and reversal. 1977

J E Terry

Ocular mydriatics are diagnostic agents that generally facilitate a preferable ophthalmoscopic examination. However, the optometrist should be aware of certain iatrogenic side effects including the precipitation of an acute angle-closure. The purpose of this paper is to summarize the mechanism of mydriatic angle-closure glaucoma. In addition, a shallow anterior chamber is a fundamental ocular variable which should be evaluated before inducing mydriasis and/or cycloplegia. The technical procedures for the oblique illumination shadow test and the van Herick slit lamp test are presented, both of which provide an accurate estimation of the anterior chamber angle. The risk of precipitating an attack after reasonable circumspection by such evaluations approaches zero. However, should an attack occur, the procedures to rapidly lower the intraocular pressure and open the chamber angle are discussed.

UI MeSH Term Description Entries
D009184 Mydriatics Agents that dilate the pupil. They may be either sympathomimetics or parasympatholytics. Cycloplegic,Cycloplegics,Mydriatic,Mydriatic Effect,Mydriatic Effects,Effect, Mydriatic,Effects, Mydriatic
D005128 Eye Diseases Diseases affecting the eye. Eye Disorders,Eye Disease,Eye Disorder
D005901 Glaucoma An ocular disease, occurring in many forms, having as its primary characteristics an unstable or a sustained increase in the intraocular pressure which the eye cannot withstand without damage to its structure or impairment of its function. The consequences of the increased pressure may be manifested in a variety of symptoms, depending upon type and severity, such as excavation of the optic disk, hardness of the eyeball, corneal anesthesia, reduced visual acuity, seeing of colored halos around lights, disturbed dark adaptation, visual field defects, and headaches. (Dictionary of Visual Science, 4th ed) Glaucomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000867 Anterior Chamber The space in the eye, filled with aqueous humor, bounded anteriorly by the cornea and a small portion of the sclera and posteriorly by a small portion of the ciliary body, the iris, and that part of the crystalline lens which presents through the pupil. (Cline et al., Dictionary of Visual Science, 4th ed, p109) Anterior Chambers,Chamber, Anterior,Chambers, Anterior

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