title: Medication-induced acute angle closure attack.
abstract: OBJECTIVE
  To review acute angle closure attacks induced by local and systemic medications.
  
  
  METHODS
  PubMed literature searches up to August 2011.
  
  
  METHODS
  The following key words were used for the search: "drug", "iatrogenic", "acute angle closure glaucoma".
  
  
  METHODS
  A total of 86 articles were retrieved using the key words. Only those concerning acute angle closure attack triggered by local or systemic drug administration were included. For articles on the same or related topics, those published at later or more recent dates were selected. As a result, 44 articles were included and formed the basis of this review.
  
  
  RESULTS
  An acute attack of angle closure can be triggered by dilatation of the pupil, by anatomical changes in the ciliary body and iris, or by movement of the iris-lens diaphragm. Local and systemic medications that cause these changes have the potential to precipitate an attack of acute angle closure. The risk is higher in subjects who are predisposed to the development of angle closure. Many pharmaceutical agents including ophthalmic eyedrops and systemic drugs prescribed by general practitioners and various specialists (in psychiatry, otorhinolaryngology, ophthalmology, medicine, and anaesthesia) can precipitate an acute angle closure attack. The medications include: anti-histamines, anti-epileptics, antiparkinsonian agents, antispasmolytic drugs, mydriatic agents, sympathetic agents, and botulinum toxin.
  
  
  CONCLUSIONS
  Since acute angle closure attack is a potentially blinding eye disease, it is extremely important to be vigilant and aware of ophthalmic and systemic medications that can lead to such attacks in predisposed subjects and to diagnose the condition when it occurs.
authors.affiliation: Eye Institute, The University of Hong Kong, Room 301, Level 3, Block B, 100 Cyberport Road, Cyberport 4, Hong Kong. laism@hku.hk
authors.forename: Jimmy S M
authors.initials: JS
authors.lastname: Lai
authors.forename: Rita A
authors.initials: RA
authors.lastname: Gangwani
mesh_terms: D000208:Acute Disease; D000927:Anticonvulsants / Q000009:adverse effects; D000928:Antidepressive Agents / Q000009:adverse effects; D018680:Cholinergic Antagonists / Q000009:adverse effects; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced*; D006801:Humans; D009184:Mydriatics / Q000009:adverse effects; D012307:Risk Factors
chemical_list: D000927:Anticonvulsants; D000928:Antidepressive Agents; D018680:Cholinergic Antagonists; D009184:Mydriatics