Table 1.
Drugs reported to induce acute angle closure glaucoma
| Medication class | Examples | Indications | Mechanism of angle closure | Ocular effects |
|---|---|---|---|---|
| α1-adrenergic agonists | Phenylephrine | Nasal decongestant, mydriatic, and vasopressor | Pupillary block | Mydriasis |
| Ephedrine | Vasopressor | |||
| β2-adrenergic agonists | Albuterol and salbutamol | Bronchodilator | Pupillary block | Mydriasis and increased aqueous humor production |
| Anticholinergic agents | Atropine | Mydriatic, cycloplegic, and bradycardia treatment | Pupillary block | Mydriasis and cycloplegia |
| Glycopyrrolate | Neuromuscular blockage reversal and decrease in airway secretions | |||
| Oxybutynin | Urge incontinence | |||
| Scopolamine | Antinausea | |||
| Botulinum toxin | Strabismus, blepharospasm, wrinkles, and headaches | |||
| Antihistamines (anticholinergic side effects) | Cetirizine, loratadine | Allergy medication | Pupillary block | Mydriasis |
| Cholinergic agents | Pilocarpine | Pupillary block angle closure and dry mouth treatment | Anterior displacement of the lens–iris diaphragm | Miosis and anterior rotation of the lens–iris diaphragm |
| Sulfonamides | Topiramate | Seizure and migraine treatment | Anterior displacement of the lens–iris diaphragm | Choroidal effusion |
| Acetazolamide | Antiglaucoma, altitude sickness, Meniere's disease treatment, and diuretic | |||
| Methyl-sulfonyl-methane (MSM) supplement | Detox supplements | |||
| Serotonergic agents | Venlafaxine and escitalopram | Antidepressant | Pupillary block/anterior displacement of lens–iris diaphragm | Mydriasis and increased aqueous humor production, choroidal effusion |
| Triptans | Migraine treatment | Pupillary block | Mydriasis, increased aqueous humor production | |
| Aripiprazole | Antipsychotic | Pupillary block | Mydriasis, increased aqueous humor production |