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Tropicamide may, in very rare cases [1], cause an attack of acute angle-closure glaucoma.
With acute angle-closure glaucoma, the pupil is generally fixed in mid-position, oval, and responds sluggishly to light, if at all.
Also, effects such as skin flushing, tachycardia, acute angle-closure glaucoma, nausea, palpitations and headache have been observed.
Pilocarpine has been used in the treatment of chronic open-angle glaucoma and acute angle-closure glaucoma for over 100 years.
Since glaucomflecken is associated with acute angle-closure glaucoma, sign for the latter can be present such as shallow anterior chamber, closed angle, hypermetropia etc.
Acute angle-closure glaucoma is caused by a rapid or sudden increase in pressure inside the eye, called intraocular pressure (IOP).
People who are farsighted (called hyperopia) are at an increased risk for acute angle-closure glaucoma because their anterior chambers are shallow and their angles are narrow.
In acute angle-closure glaucoma cases, surgical iridectomy has been superseded by Nd:YAG laser iridotomy, because the laser procedure is much safer.
Ujino H, Morimoto O, Yukioka H, Fujimori M. [Acute angle-closure glaucoma after total hip replacement surgery].
A wide angle allows sufficient drainage of humour through the trabecular meshwork (unless obstructed), whereas a narrow angle may impede the drainage system and leave the patient susceptible to acute angle-closure glaucoma.
Nd:YAG lasers are used in ophthalmology to correct posterior capsular opacification, a condition that may occur after cataract surgery, and for peripheral iridotomy in patients with acute angle-closure glaucoma, where it has superseded surgical iridectomy.