Published evidence has not established whether significant hazard exists in systemically administering anticholinergic drugs to patients with open-angle glaucoma with no question of angle closure. In an earlier study we concluded that two doses of atropine sulfate (0.6 mg) given four hours apart had no significant influence on intraocular pressure. In this study tonography was performed on 21 patients with chronic open-angle glaucoma before and after taking atropine sulfate 0.6 mg three times a day for seven days. In a separate test pressure measurements were made one hour after one drop of cyclopentolate hydrochloride was applied directly to the eyes of the same patients. Those eyes which showed a rise in pressure after cyclopentolate also tended to show a rise after one week of orally taken atropine, while the converse was also true. It is concluded that systemically administered anticholinergic drugs are safe for most patients with chronic open-angle glaucoma but that pretesting with cyclopentolate may help identify those patients which should be closely observed while receiving these drugs.
Lazenby GW, Reed JW, Grant WM. Anticholinergic Medication in Open-Angle GlaucomaLong-Term Tests. Arch Ophthalmol. 1970;84(6):719-723. doi:10.1001/archopht.1970.00990040721003