The Effect of Pilocarpine on the Visual Field in Normals

An Interprofessional Study of the Effects of Topical Pilocarpine on Oral and Visual Function

“…Topical pilocarpine significantly reduced the field of vision affecting more of the peripheral field than central field. The effects of pilocarpine on automated perimetry was consistent with previous studies (McCluskey et al, 1986;Webster et al, 1993).…”

“…Stimulation of peripheral muscarinic receptors produces salivation, lacrimation, sweating, rhinorrhea, bronchospasm, urinary frequency, diarrhea, bradycardia, and miosis. It is generally known that miosis induced by topical pilocarpine can adversely affects visual field, and ciliary spasm can cause reduction in accommodation and visual acuity (McCluskey et al, 1986;Gilmartin, Amer, & Ignleby, 1995). Although there have been a number of studies over the past few decades on the effects of topical pilocarpine on high-contrast visual acuity and visual field with respect to glaucoma treatment, little has been done to investigate the potential effect of topical pilocarpine on low-contrast visual acuity which is encountered in many daily environmental settings.…”

Pupil size and Perimetry—a pharmacological model using increment and decrement stimuli

“…However, we know of no such studies. Earlier pharmacological studies on the influence of pupil size on perimetry applied relatively strong medication (phenylephrine 10% [22,23,31], pilocarpine 2% [11, 16,23], tropicamide 1% [12], thymoxamine 0.5% [17,31]), possibly affecting other visual functions [11,20,27]. In this study the medication dosage was kept low to minimize interference with accommodation or visual acuity and to keep pupillary size within the range encountered in normative studies [25].…”

“…In contrast, pharmacologically [3, 5, 6, 8, 10-12, 16, 17, 23, 31] or physically [9] induced intra-individual differences in pupil diameter do seem to have an effect. This effect appears to be more marked in glaucoma patients [3,5,6,8,10,23] than in normal subjects [11,12,16,17,31]. Both pharmacological contraction [6,11] and dilation [12,23] of the pupil appear to cause an increase in mean defect.…”

“…Dark stimuli cause less scatter inducing diffuse retinal illumination, which is suspected to play a major role in the effect of pupil size on perimetric results obtained with bright stimuli [9,11,16]. However, there is no literature pertaining to the effect of pupil size on perimetry using dark stimuli.…”