BMJ 1995;310:1668 (24 June)

Letters

Anticholinergic drugs are not contraindicated after iridotomy

EDITOR,--In his review of the drug treatment of Parkinson's disease Niall Quinn states mistakenly that anticholinergic drugs are contraindicated in narrow angle glaucoma.1 Similar misleading advice continues to be published in various pharmacopoeias (for example, the British National Formulary) with reference to other drugs with anticholinergic effects, including antidepressants and bladder relaxants. In addition, general practitioners commonly cite a history of glaucoma as a reason for not dilating patients' eyes when screening for diabetic retinopathy.2

When acute narrow angle glaucoma is confirmed laser iridotomy should be performed to prevent any recurrence; this renders pupil dilatation safe. Chronic open angle glaucoma, by definition, does not predispose to angle closure. When doubt persists the eye department should be consulted.

Acute narrow angle glaucoma is rare and confined almost exclusively to people with severe hypermetropia and elderly people. Good practice dictates that patients should always be warned about potential side effects of newly . . . [Full text of this article]


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Relevant Article

Fortnightly Review: Drug treatment of Parkinson's disease
Niall Quinn
BMJ 1995 310: 575-579. [Abstract] [Full Text]

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