Sympathomimetic substances to "whiten and soothe" the eye are incorporated in numerous proprietary collyria. Phenylephrine, usually in ⅛% (0.125%) solution, is one such commonly used decongestant found in combination with a variety of agents, including antibiotics and sulfa drugs, corticosteroids, antihistamines, local anesthetics, antiseptics, and astringents. Indeed, even "over-the-counter" collyria contain phenylephrine and other eye whiteners.
Until recently, we had thought the mydriatic effect of so dilute a solution as ⅛% phenylephrine to be inconsequential. Reported herein is a case of acute angle-closure glaucoma which led us to a critical examination of this supposition. Pertinent data being scarce, we decided to test the mydriatic action of ⅛% phenylephrine, the better to evaluate its safe or potentially hazardous use in the narrow-angle eye.
Report of Case
A 62-year-old white female complaining of itchy eyes sought the help of an ophthalmologist. Fourteen years previously she had had successful fistulizing surgery performed upon
WEISS DI, SHAFFER RN. Mydriatic Effects of One-Eighth Per Cent PhenylephrineA Potential Cause of Angle-Closure Glaucoma. Arch Ophthalmol. 1962;68(6):727-729. doi:10.1001/archopht.1962.00960030731005