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December 1962

Mydriatic Effects of One-Eighth Per Cent Phenylephrine: A Potential Cause of Angle-Closure Glaucoma

Author Affiliations

New York,; San Francisco
NINDB Special Fellow in Ophthalmology (Dr. Weiss).; From the Department of Ophthalmology and the Glaucoma Clinic, University of California Medical Center.

Arch Ophthalmol. 1962;68(6):727-729. doi:10.1001/archopht.1962.00960030731005

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

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