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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
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Abstract

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

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