Pilocarpine induced acute angle closure

BMJ Case Rep. 2012 May 8:2012:bcr0120125694. doi: 10.1136/bcr.01.2012.5694.


A 34-year-old Caucasian female with advanced primary angle closure glaucoma developed acute angle closure following administration of g.pilocarpine 2% given as preparation for laser peripheral iridotomies. Subsequent investigations supported an underlying diagnosis of spherophakia with no systemic associations. She required peripheral iridotomies, bilateral clear lens extractions and left cyclodiode laser to control her intraocular pressures. This case highlights the situations when pilocarpine should be given with caution and also the increasing role of phacoemulsification as an alternative to filtration surgery in primary angle closure glaucoma management.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Administration, Topical
  • Adult
  • Female
  • Glaucoma, Angle-Closure / chemically induced*
  • Humans
  • Muscarinic Agonists / administration & dosage
  • Muscarinic Agonists / adverse effects*
  • Pilocarpine / administration & dosage
  • Pilocarpine / adverse effects*
  • Visual Acuity


  • Muscarinic Agonists
  • Pilocarpine