Why Is Epinephrine Contraindicated in Closed Angle Glaucoma

These agents stimulate both alpha-1 and alpha-2 adrenergic receptors, thus topical administration can induce transient mydriasis, either with or without the use of concomitant miotic agents. In patients with narrow angles, any degree of pupillary dilation can provoke an acute attack of angle-closure glaucoma.

Which drug is contraindicated in closed-angle glaucoma?

Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective.

How does adrenaline decrease IOP?

Previous studies have focused on the effect of adrenaline on aqueous humor formation from ciliary body, suggesting that topical administration of adrenaline can reduce both the blood flow to the ciliary body[9,10] and active secretion of it,[20,21] thus reduces IOP.