Acute angle closure glaucoma precipitated by intranasal application of cocaine

J Laryngol Otol. 1999 Mar;113(3):250-1. doi: 10.1017/s0022215100143695.


We describe a patient who developed acute angle-closure glaucoma following the application of topical intranasal cocaine. A 46-year-old woman underwent an elective antral washout under general anaesthesia and with local application of 25 per cent cocaine paste to the nasal mucosa. Twenty-four hours post-operatively the patient developed sudden painful blindness which was found to be due to acute glaucoma. Cocaine with its indirect sympathomimetic activity causes mydriasis, that can precipitate acute angle-closure glaucoma in predisposed individuals with a shallow anterior chamber. Although the incidence is rare, otolaryngologists need to be aware of this potential complication.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Administration, Intranasal
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / adverse effects*
  • Cocaine / administration & dosage
  • Cocaine / adverse effects*
  • Female
  • Glaucoma, Angle-Closure / chemically induced*
  • Humans
  • Iatrogenic Disease*
  • Middle Aged
  • Paranasal Sinus Diseases / therapy
  • Sinusitis / therapy


  • Anesthetics, Local
  • Cocaine