Cycloplegic-Induced Intraocular Pressure Elevations

Abstract

Cycloplegics may cause elevations of intraocular pressure in certain eyes in the absence of angle closure of any degree. The incidence of this response is 23% in a population with proven open-angle glaucoma and 2% in an apparently normal population. Consequently, any patient having a significant intraocular pressure elevation and open angles after routine dilatation with cycloplegics should be considered an open-angle glaucoma suspect. Patients exhibiting this phenomenon respond to all of the potent cycloplegic agents and not at all to those with a minimal effect on accommodation. The mechanism of this phenomenon is discussed in relation to evidence from other investigations.