Pupillary block glaucoma

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). 

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. 

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... 

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. 

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... 

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

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. 

Muscarinic cholinomimetics mediate contraction of the circular pupillary constrictor muscle and of the ciliary muscle. Contraction of the pupillary constrictor muscle causes miosis, a reduction in pupil size. Miosis is usually present in patients exposed to large systemic or small topical doses of cholinomimetics, especially organophosphate cholinesterase inhibitors. Ciliary muscle contraction causes accommodation of focus for near vision. Marked contraction of the ciliary muscle, which often occurs with cholinesterase inhibitor intoxication, is called cyclospasm. Ciliary muscle contraction also puts tension on the trabecular meshwork, opening its pores and facilitating outflow of the aqueous humor into the canal of Schlemm. Increased outflow reduces intraocular pressure, a very useful result in patients with glaucoma. All of these effects are prevented or reversed by muscarinic blocking drugs such as atropine. 

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