Cycloplegic-Induced Intraocular Pressure Elevations

Changes in intraocular pressure following diagnostic mydriasis with cyclopentolate 1%

“…This is inconsistent with studies which have reported that the rise in IOP reaches its peak at 45 min post dilatation. 1 The relative delay in IOP peak seen in our patient might be due to the Trusopt (Dorzolamide) drops he was using, or an abnormality with aqueous inflow and outflow dynamics related to his POAG. Equally our chosen time period of re-examination may not be the time of peak pressure change.…”

“…In this study the patients with significant rises in IOP were treated immediately to decrease the risk of any chance of damage to the optic nerve. Other studies have suggested that if untreated the rise in IOP is likely to be sustained for between 4 and 6 h. 1 Does this undetected rise in IOP in some patients represent a clinically significant risk of damage to the optic nerve, and if so, should we routinely re-check IOP following administration of cycloplegics? In eyes that have no history of glaucoma it is likely that this undetected rise will have little clinical significance.…”

“…Maximum cycloplegia is found to occur in 30-60 min. 1 It is well recognised that cycloplegic agents can cause a significant rise in intraocular pressure in susceptible patients. With the advent of gonioscopy it was found that a narrow angle was a crucial factor in predisposing to acute IOP elevation.…”

“…5 Cycloplegics have been shown to cause significant IOP elevation in only 2% of the apparently normal population, increasing to 23% of patients with known primary open angle glaucoma. 1,6 We aimed to assess the effect of diagnostic mydriasis with cyclopentolate on the IOP of patients with a range of different ophthalmic conditions, presenting to routine glaucoma, medical retina and cataract clinics. The possible implications of routinely dilating such patients in this clinical setting are clearly relevant to everyday practice.…”

Delayed intraocular pressure elevation after pupillary dilation in exfoliation syndrome

“…Acute elevation of IOP in patients with POAG after pharmacological mydriasis has been well documented (Harris 1968;Shaw & Lewis 1986). Elevated IOP after cyclopentolate was demonstrated in 23% of patients with POAG but in only 2% of normal controls (Harris 1968).…”