BMJ  2006;332:179 (21 January), doi:10.1136/bmj.332.7534.179

Letter

Funduscopy: to dilate or not?

Precipitation of angle closure may not be a disservice

The first 150 words of the full text of this article appear below.

Editor—Liew et al encourage clinicians to dilate pupils for thorough funduscopy.¹ The rare occurrence of precipitated angle closure with tropicamide 0.5% may not necessarily be a disservice to the patient, for two reasons.

Firstly, anyone whose angle may be provoked into closure by a mild mydriatic is at risk of spontaneous angle closure glaucoma. The fact that it has been precipitated in a healthcare setting, rather than occurring in the community, is of some benefit. The patient is likely to be within easy access of specialist care. We see patients who are at risk of angle closure but who, for example, have a propensity to travel (either during the day or for extended durations, as with the armed forces) or who cannot travel (because of being snow bound without ambulance access for several days).

Secondly, such angle closure would occur shortly after dilating drops are wearing off. Thus the symptoms . . . [Full text of this article]

Department of Ophthalmology, Huddersfield Royal Infirmary, Huddersfield HD3 3EA starfish1944@yahoo.com

Department of Ophthalmology, Huddersfield Royal Infirmary, Huddersfield HD3 3EA

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Relevant Article

Fundoscopy: to dilate or not to dilate?

Gerald Liew, Paul Mitchell, Jie Jin Wang, and Tien Yin Wong
BMJ 2006 332: 3. [Extract] [Full Text] [PDF]

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