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BMJ Case Reports 2012; doi:10.1136/bcr.01.2012.5694
  • Unexpected outcome (positive or negative) including adverse drug reactions

Pilocarpine induced acute angle closure

  1. Paul J Foster1,2
  1. 1NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, United Kingdom
  2. 2Glaucoma Department, Moorfields Eye Hospital, London, UK
  1. Correspondence to Mr Alexander C Day, alex.day{at}ucl.ac.uk

Summary

A 34-year-old Caucasian female with advanced primary angle closure glaucoma developed acute angle closure following administration of g.pilocarpine 2% given as preparation for laser peripheral iridotomies. Subsequent investigations supported an underlying diagnosis of spherophakia with no systemic associations. She required peripheral iridotomies, bilateral clear lens extractions and left cyclodiode laser to control her intraocular pressures. This case highlights the situations when pilocarpine should be given with caution and also the increasing role of phacoemulsification as an alternative to filtration surgery in primary angle closure glaucoma management.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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