Doctor insights on:
Safe Antidepressants Acute Narrow Angle Glaucoma
Speak with your doc: Certain antidepressants have been associated with causing narrow angles to worsen. This can increase your risk of an acute narrow angle glaucoma attack, which is sight-threatening. An acute attack is incredibly painful and needs immediate treatment in order to prevent blindness. See an eye doctor to discuss your glaucoma and speak with your psychiatrist about medication choices as well. ...Read more
Can trigger episode: Xanax (alprazolam) can cause involuntary twitching of muscle fibers. If you have acute narrow angle glaucoma, where the fluid in your eye has trouble draining, an involuntary twitch of the iris dilator muscle can completely block your eye fluid from draining. This will cause your eye pressure to increase rapidly and cause severe glaucoma. ...Read more
May raise pressure: Xanax (alprazolam) can cause intraocular pressure in the eyes to go up. Even though it is generally a muscle relaxant, it may cause muscle spasms in the iris which controls the size of your pupil. If the iris contracts and blocks drainage of fluid in your eye, then pressure can build up and you may experience severe pain, blurry vision ; nausea/ vomiting. U should check w/ an ophthalmologist re: glaucoma tx. ...Read more
Laser: Have you had laser peripheral iridotomy and/or goniotomy to prevent closure? The medications that can exacerbate angle closure are anything that dilates the eye, Antihistamines and decongestants; Asthma medicines; Motion sickness medicines, and some medicines used to treat depression (tricyclic antidepressants) ...Read more
Is there a safe sinus relief medication for a person with narrow angle glaucoma? I have had bilateral iridotomy
It depends: Sometimes, despite iridotomies, the angle may remain narrow and any drugs that cause pupil dilation, either systemic or nasal spray, can increase angle closure and cause elevated pressure. I will sometimes recommend a mild nasal steroid if there is no evidence of infection. You need to consult with your eye surgeon as to the severity of your narrow angles and weigh risks/benefits of treatment. ...Read more
Open angles are okay: Glycopyrrolate is an anticholinergic, which has a potential effect on patients with NARROW angle glaucoma. The effects can transiently dilate the pupil, which in turn can congest the angle where the natural drainage system is. This effect can be too much in a narrow angle eye where the angle is already compromised. This can lead to acutely increased eye pressures and worsen glaucoma. Good luck! ...Read more
Glycopyrrolate is an antimuscarinic agent and could make your pupils dilate. If you have an angle prone to acute angle closure, this drug could induce an attack.
I am curious why you ask about this drug, as it is not something normally prescribed by any clinic doctor and commonly only used by anesthesiologists during general anesthesia. ...Read more
It can increase IOP:
Http://answers. Yahoo. Com/question/index? Qid=20090328145710aa3jfbq
it has anti-cholinergic properties that can cause intra-ocular pressure in the eye to increase, due to obstruction of the normal flow of fluid out of the eye. The link above explains it in more detail. ...Read more
Serious eye problem: Angle closure is when the outflow of aqueous humor is completely blocked and the eye pressure builds up to dangerous levels potentially causing blindness sometimes within 24 hours. It is more common in Asian and native american populations particularly in alaskan eskimos. ...Read more
Pain, blur: Intermittent or early angle closure may have no symptoms, or may manifest with pain, aching over the brow, blurred vision, seeing haloes around lights. Other things can also cause these symptoms, but if you are having them, they warrant evaluation with a complete exam. ...Read more
Could cause pressure: Valium is a muscle relaxant which selectively affects skeletal muscle fibers more than smooth muscle fibers found in the iris and pupil. The thinking would be that if Valium or diazepam relaxes the iris muscles it could trigger angle closure glaucoma -a medical emergency. I've never seen that happen to a patient on Valium and if you have a laser iridotomy it will prevent this. ...Read more
It depends: Valium belongs in a class of medications that, in theory, could precipitate an angle closure attack (as a weak anticholinergic). In practice, this is not an absolute contraindication. What is more important is to ensure that your narrow angles are managed by your ophthalmologist (either with laser+/-medication). ...Read more
Increased IOP: While levodopa/carbidopa primarily is a dopaminergic agent, there may be cross-over onto cholinergic receptors. These receptors are generally responsible for pupil dilation which can cause narrowing of the angle which can increase eye pressure. A laser iridotomy may help in some cases but not all. The medication could be tried if needed, with careful supervision by an ophthalmologist. ...Read more
Anatomical Proble: Angle closure glaucoma is far less common than open angle glaucoma. The pathology is based on an anatomical narrowing of the drainage site where fluid made inside the eye drains out. Think plumbing: a clogged drain backs up, and in the eye the pressure increases dramatically. Very painful and vision can be lost entirely in a few hours. High risk patients should be treated, but only if high risk. ...Read more
Yes: Just need a correct corneal fitting, doesn't affect the drain of the eye. ...Read more
Glaucoma: The angle is defined by the cornea and the iris. If the angle is narrow, there is less space for aqueous fluid to leave the eye through an area called the trabecular meshwork. A closed angle is completely blocked from aqueous egress. The treatment for this is a simple laser procedure. Contact your ophthalmologist if you are concerned about this condition. ...Read more
Glaucoma types: Most glaucoma is open angle - the fluid drainage space in the front is wide and the drains within it are obstructed leading to increased pressure over time. Narrow angle, mostly in hyperopes (those with eyeglass lenses that act as magnifiers), can in older folks (over 50 or so), quickly within hours mechancially block fluid flow causing an acute glaucoma attack. This is an emergency! ...Read more
Of course: If you know you have narrow angle glaucoma, you probably have had the diagnosis made and the treatment (laser peripheral iridotomy) already administered. There is no relationship between these features and the ability to wear contacts. So if that is your wish, discuss with you ophthalmologist to get the proper design and fit. ...Read more
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