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To the Editor:
Following retrobulbar lidocaine (Xylocaine) injection for a cataract extraction, the tension was recorded to be about 17 mm of Hg with the 5.5 gm weight. Upon massaging the globe, dilatation of the pupil started and recheck of tension revealed 25 mm of Hg with 5.5 gm weight. When the eye was massaged further, the pupil dilated still further and the tension rose to about 45 mm of Hg without any signs of exophthalmos. Then it was realized that the angle had closed following dilatation of the pupil. Pilocarpine, 2%, was instilled and the pupil started to contract, and along with the pupillary contraction, the tension came down steadily to below 12 mm of Hg; and then the globe was opened.Does this not necessitate gonioscoping all eyes in preparation for cataract extraction, or at least checking tension following retrobulbar injections (except eyes under the effect of some
Atchoo P. ANGLE-CLOSURE AFTER RETROBULBAR INJECTION. Arch Ophthalmol. 1964;71(2):292. doi:10.1001/archopht.1964.00970010308035
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