Mydriatic effects of one-eight per cent phenylephrine. A potential cause of angle-closure glaucoma.

Sympathomimetic substances to "whiten and soothe" the eye are incorporated in numerous proprietary collyria. Phenylephrine, usually in ⅛% (0.125%) solution, is one such commonly used decongestant found in combination with a variety of agents, including antibiotics and sulfa drugs, corticosteroids, antihistamines, local anesthetics, antiseptics, and astringents. Indeed, even "over-the-counter" collyria contain phenylephrine and other eye whiteners. Until recently, we had thought the mydriatic effect of so dilute a solution as ⅛% phenylephrine to be inconsequential. Reported herein is a case of acute angle-closure glaucoma which led us to a critical examination of this supposition. Pertinent data being scarce, we decided to test the mydriatic action of ⅛% phenylephrine, the better to evaluate its safe or potentially hazardous use in the narrow-angle eye. Report of Case A 62-year-old white female complaining of itchy eyes sought the help of an ophthalmologist. Fourteen years previously she had had successful fistulizing surgery performed upon