Pupillary block

Medications with anticholinergic properties induce mydriasis, which can lead to angle closure in pupillary block and plateau iris. Pupillary block may also be induced by drugs that cause miosis.12... 

Hypersensitivity to any component of the formulation where constriction is undesirable (eg, acute iritis, acute or anterior uveitis, some forms of secondary glaucoma, pupillary block glaucoma, acute inflammatory disease of the anterior chamber). 

Pupillary block with secondary angle-closure glaucoma Band keratopathy ... 

The goal of dilation should be a maximally dilated pupil. Minimally dilated or pupils that remain in a mid-dilated state pose a risk of pupillary-block glaucoma in eyes with narrow angles that is not present with maximally dilated pupils. 

Eyes with deep anterior chambers are essentially free of the risk of pupillary block and iris bombe. However, in eyes predisposed to angle-closure glaucoma, the lens is generally displaced anteriorly, which increases the pressure of the iris against the lens. This situation lavors pupillary block and iris bombe with subsequent secondary angle closure. 

Peripheral iridectomy or iridotomy removes the risk of pupillary block by creating a channel between the... 

Figure 20-7 Pupillary block causes increased pressure in the posterior chamber relative to the anterior chamber. This produces iris bombe, which obstructs aqueous outflow and causes secondary angle closure.

If pupillary capture persists, secondary complications can occur, including pupillary block glaucoma, iris chafing, iris sphincter erosion, and disruption of the blood-aqueous barrier with secondary inflammation... 

Posterior synechia, with pupillary block resulting from inflammation and adhesion of the iris to the lens or vitreous... 

Other reported complications include pupillary block glaucoma, secondary glaucoma, and corneal complications, including band-shaped keratopathy (11). Pupillary block in aphakic eyes can be prevented by placing peripheral iridectomy at the 6 o clock position, since silicone is lighter than water. 

Two major types of classic, reversible primary CAG have been described CAG with pupillary block and CAG withont pnpfllary block. CAG with pupillary block results when the iris is in firm contact with the lens. This produces a relative block of aqueous flow through the pupil to the anterior chamber (pupillary block), resulting in a bowing forward of the iris, which blocks the trabecnlar meshwork. CAG with pupillary block occurs most commonly when the pupil is in mid-dilation. In this position, the combination of pnpfllary block and relaxed iris allows the greatest bowing of the iris however, angle closure may occur during miosis or mydriasis. 

CAG withont pupillary block occurs in patients with an abnormality called a plateau iris. The ciliary processes in these cases are situated anteriorly, which indent the iris forward and canse closure of the trabecular meshwork, especially during mydriasis. The mydriasis prodnced by anticholinergic dmgs or any other drng resnlts in precipitation of both types of CAG glancoma, whereas dmg-indnced miosis may prodnce pnpfllary block. 

Physostigmine (eserine) 0.25% ointment Glaucoma, accommodative esotropia, louse and mite infestation of lashes Retinal detachment, miosis, cataract, pupillary block glaucoma, iris cysts, brow ache, punctal stenosis of the nasolacrimal system... 

Further deposits are then applied along the circumference of the iris so as to displace the entire access to the area behind the iris. An inverted pupillary block is achieved, to an extent, which then allows the anterior chamber to deepen at the expense of the posterior chamber. Only now is the remaining anterior chamber space filled with viscoelastic. 

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