title: Glycopyrrolate induced bilateral angle closure glaucoma after cervical spine surgery.
abstract: To report a case of bilateral acute angle closure glaucoma (AACG) that occurred after cervical spine surgery with the use of glycopyrolate. A 59-year-old male who presented with severe bilateral bifrontal headache and eye pain that started 12 h postextubation from a cervical spine surgery. Neostigmine 0.05 mg/kg (4.5 mg) and glycopyrrolate 0.01 mg/kg (0.9 mg) were used as muscle relaxant reversals at the end of the surgery. Ophthalmic examination revealed he had bilateral AACG with plateau iris syndrome that was treated medically along with laser iridotomies. Thorough examination of anterior chamber should be performed preoperatively on all patients undergoing surgeries in the prone position and receiving mydriatic agents under general anesthesia.
authors.affiliation: Department of Ophthalmology, American University of Beirut Medical Center; Beirut, Lebanon.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Jaroudi
authors.forename: Maalouf
authors.initials: M
authors.lastname: Fadi
authors.forename: Fadi
authors.initials: F
authors.lastname: Farah
authors.forename: Georges M
authors.initials: GM
authors.lastname: El Mollayess
mesh_terms: D000208:Acute Disease; D000759:Adjuvants, Anesthesia / Q000009:adverse effects*; D000867:Anterior Chamber / Q000601:surgery; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002574:Cervical Vertebrae / Q000601:surgery*; D003131:Combined Modality Therapy; D015812:Glaucoma, Angle-Closure / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D006024:Glycopyrrolate / Q000009:adverse effects*; D006801:Humans; D007796:Laminectomy; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D009388:Neostigmine / Q000627:therapeutic use; D010277:Parasympathomimetics / Q000627:therapeutic use
chemical_list: D000759:Adjuvants, Anesthesia; D000959:Antihypertensive Agents; D010277:Parasympathomimetics; D009388:Neostigmine; D006024:Glycopyrrolate
keywords: Acute Angle Closure Glaucoma; Cervical Spine Surgery; Glycopyrrolate