Hostname: page-component-745bb68f8f-cphqk Total loading time: 0 Render date: 2025-02-10T11:05:45.411Z Has data issue: false hasContentIssue false
  • English
  • Français

Acute angle closure glaucoma precipitated by intranasal application of cocaine

Published online by Cambridge University Press:  29 June 2007

C. K. Hari ,
D. G. Roblin ,
M. I. Clayton  and
R. G. Nair
C. K. Hari*
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Royal Gwent Hospital, Newport, Gwent, South Wales, UK.
D. G. Roblin
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Royal Gwent Hospital, Newport, Gwent, South Wales, UK.
M. I. Clayton
Affiliation:
Department of Otolaryngology and Head and Neck Surgery, Royal Gwent Hospital, Newport, Gwent, South Wales, UK.
R. G. Nair
Affiliation:
The Department of Ophthalmology, East Glamorgan General Hospital, Mid Glamorgan, South Wales, UK.
*
Address for correspondence: Mr C. K. Hari, F.R.C.S., Department of Otolaryngology and Head and Neck Surgery, Royal Gwent Hospital, Newport NP9 2UB. e mail: ckhari@bigfoot.com
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Keywords

CocaineAnaesthesia, localGlaucoma, angle-closure
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 3 , March 1999 , pp. 250 - 251
Copyright
Copyright © JLO (1984) Limited 1999

References

Bailey, B. J. (1996) Looking back at a century of cocaine-use and abuse. Laryngoscope 106: 681–683.CrossRefGoogle Scholar
British National Formulary (1998) Local anaesthesia (Mehta, D. K., Matrin, J., eds.) 35: British Medical Association and Royal Pharmaceutical Society of Great Britain, London, pp 550–553.Google Scholar
Fazio, D. T., Bateman, J. B., Christensen, R. E. (1985) Acute angle closure glaucoma associated with surgical anaesthesia. Archives of Ophthalmology 103: 360–362.CrossRefGoogle Scholar
Javaid, J. I., Fischman, M. W., Schuster, C. R., Dekirmenjian, H., Davis, J. M. (1978) Cocaine plasma concentration: Relation to physiological and subjective effects in humans. Science 202: 227.CrossRefGoogle ScholarPubMed
Mitchell, J. D., Schwartz, A. L. (1996) Acute angle closure glaucoma associated with intranasal cocaine abuse. American Journal of Ophthalmology 112(3): 425–426.CrossRefGoogle Scholar
Moffett, A. J. (1947) Nasal analgesia by pastural instillation. Anaesthesia 2: 31–34.Google Scholar
Moroi, S. E., Lichter, P. R. (1996) Ocular pharmacology. In Goodman and Gilman's The Pharmacological Basis of Therapeutics 9th Edition. (Hardman, J. G., Limbird, L. E., eds.) McGraw-Hill, New York, pp 1619–1645.Google Scholar
Orlick, M. E., Kastl, A. R., Donzis, P. B., Howard, R., Rice, J., Tauber, S. (1990) Ocular effects and detection in tears of aerosolized intranasal cocaine and fluorescein. Annals of Ophthalmology 22: 249–254.Google ScholarPubMed
Skuta, G. L. (1994) Angle closure glaucomas. In the Textbook of Ophthalmology. Volume 7 (Podds, S. M., Yanoff, M., eds.) Mosby, London, pp 8.7–8.28.Google Scholar
Wilkinson, P., Dyke, C. V., Jatlow, P., Barash, P., Byck, R. (1980) Intranasal and oral cocaine kinetics. Clinical Pharmacology and Therapeutics 27: 386–394.CrossRefGoogle ScholarPubMed