Mydriasis caused

FIGURE 14.6 Miosis and mydriasis caused by autonomic drugs. N = nerve. 

The drops should always be instilled into both eyes so that the reaction of the affected pupil can be compared with that of the normal pupil. If the condition is bilateral, as in anticholinergic mydriasis caused by systemic agents, the drop should be placed in only one eye so that the response of each pupil can be compared. 

Pilocarpine (1 to 2 drops of 2% solution 2 to 4 times daily) is used to control lOP in glaucoma. In addition, it is used in emergency relief of mydriasis in an acutely glaucomatous situation or to reverse mydriasis caused by cycloplegic agents. It may be applied topically in the form of a drug reservoir (Ocusert) (see Figure 78). 

Pilocarpine is used as its hydrochloride and possesses excitatory activity on the parasympathetic nerve system, like physostigmine (Section 2.5) and arecoline (Section 10.3). Thus, this alkaloid acts as an antagonist of atropine (Section 3.2), and it promotes the secretion of sweat, saliva, and tears and causes myosis. It is reported that subcutaneous injection of 10 mg of pilocarpine HCl causes violent sweating (0.5-1.01) and salivation (11). As an eye lotion, a 1% solution of pilocarpine HCl is used for recovery from the mydriasis caused by atropine, or for the treatment of glaucoma. 

Wilbert J (1972) Tobacco and shamanistic ecstasy among the Warrao Indians of Venezuela. In Furst PT (ed) Flesh of the gods. Praeger Publisher, New York, pp 55-83 Wilhelm H, Wilhelm B, Schiefer U (1991) Mydriasis caused by plant contact. Fortschr Opthalm 88 588-591... 

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