Significant differences in tonographic recordings after the provocative stimulus of water drinking have facilitated the separation of normal eyes from eyes with chronic simple glaucoma.1 In contradistinction, eyes with the potential for angle closure are distinct in their response to mydriasis. The mechanism of pupillary block in angle closure glaucoma and the provocative effect of active pupillary dilation upon eyes with angles seen by gonioscopy to be occludable, have been proved by Barkan,2 Chandler,3 Becker,4 and others.These two types of patients with glaucoma are quite dissimilar and would seem to be easily separable by the two tests. However, cycloplegic agents such as those used in the mydriatic provocative test for angle closure glaucoma are also capable of producing similar hypertensive ocular effects in eyes with open angle glaucoma.5,6 The mechanism of action has been unknown, although a recent study has indicated that the
CHRISTENSEN RE, PEARCE I. Homatropine Hydrobromide: Effect of Topical Administration Upon the Intraocular Pressure and Aqueous Facility Values of Normal and Chronic Simple Glaucomatous Eyes. Arch Ophthalmol. 1963;70(3):376–380. doi:10.1001/archopht.1963.00960050378019
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