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August 1991

Angle Closure Glaucoma Precipitated by Aerosolized Atropine

Author Affiliations

From the Departments of Ophthalmology (Dr G. J. Berdy) and Medicine (Dr S. S. Berdy), Harvard Medical School, and the Eye Research Institute (Dr G. J. Berdy), Boston, Mass; and the Bethesda Eye Institute, Department of Ophthalmology, St Louis (Mo) University School of Medicine (Drs Odin and Hirst). Dr Hirst is currently with the Princess Alexandra Hospital, Brisbane, Queensland, Australia; Dr G. J. Berdy is currently with the Bethesda Eye Institute, Department of Ophthalmology, St Louis University School of Medicine; and Dr S. S. Berdy is currently with the Jewish Hospital at Washington University Medical Center, St Louis, Mo.

Arch Intern Med. 1991;151(8):1658-1660. doi:10.1001/archinte.1991.00400080140028

Angle closure glaucoma is an infrequent form of glaucoma occurring when the filtration mechanism for the aqueous humor is obstructed by apposition of the peripheral iris to the trabecular meshwork. Anatomic features associated with acute-angle closure include congenitally small anterior segments, increased lens thickness, and shallow anterior chamber depth. We present two patients who developed signs and symptoms of angle closure glaucoma after receiving aerosolized atropine for treatment of chronic obstructive pulmonary disease. We recommend that before instituting therapy with an inhaled anticholinergic agent, the patient should be questioned concerning prior history of angle closure glaucoma symptoms and signs and the anterior chamber depth should be examined using iris illumination. Patients having shallow anterior chambers, or possible prior angle closure glaucoma attacks, should be examined by an ophthalmologist before inhalant anticholinergic therapy.

(Arch Intern Med. 1991;151:1658-1660)

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