Pilocarpine

Preparations:

  1. Eye drops ( 1%, 2% & 4% )
  2. Ocuserts ( Pilo – 20 & Pilo – 40 )
    • Sustained effect
    • Pilo – 20 : for patients controlled with 2%.
    • Pilo – 40 : for patients requiring higher drops
  3. Gel ( 4% )

Duration of Action: 6-8 hours

Frequency: BDS (2%) /QID ( 4% )

INDICATIONS:

  1. POAG
  2. Acute Angle Closure Glaucoma
  3. Chronic synechial angle closure
  4. Prior to Surgery : peripheral button iridotomy ( PBI ), Penetrating Keratoplasty (PKP ), YAG / LASER iridotomy.
  5. Intra op : prior to ACIOL implantation
  6. Post operative : to pull iris away from wound angle.

CONTRA-INDICATIONS :

  1. Malignant glaucoma
  2. Inflammatory glaucoma
  3. Epidemic dropsy glaucoma
  4. Glaucomocyclitic crisis
  5. Aphakic glaucoma
  6. Buphthalmos

SIDE EFFECTS:

  1. LOCAL (OCULAR):
  • Spasm of accommodation – myopia & frontal headache
  • Retinal detachment
  • Iris cyst formation
  • Mild iritis
  • Lenticular opacities
  • Follicular conjunctivitis
  1. SYSTEMIC:
  • Bradycardia
  • Diarrhea
  • Increased sweating
  • Excessive salivation
  • Anxiety
  • Scoline apnea with Disopropyl Flourophosphate : inability of patient to resume normal respiration after termination of GA.