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Dr. Atchoo's letter was referred to Dr. W. Morton Grant, who offers the following reply:
To the Editor:
Dr. Atchoo's observation of angle-closure glaucoma occurring after injection of retrobulbar anesthetic in preparation for cataract extraction is interesting and unusual.My reaction and that of Dr. Paul Chandler, with whom I have discussed the question about routine gonioscopy or tension checking, is that in the preoperative work-up of patients one should be alerted to the presence of shallow anterior chamber by the routine slit-lamp examination. In such cases gonioscopy should certainly be done. (In the Massachusetts Eye and Ear Infirmary it is.)Even in the presence of a narrow angle it is very rare in our experience to have closure and significant elevation of pressure during the approximately ten-minute interval from injection to opening of the eye. We believe we can tell satisfactorily that an eye is soft by the way
Grant WM. ANGLE-CLOSURE AFTER RETROBULBAR INJECTION-Reply. Arch Ophthalmol. 1964;71(2):293. doi:10.1001/archopht.1964.00970010308036