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Atropine for too low a pressure

Question:

Can anyone comment  about the use of Atropine eye drops to raise too low an IOP? (Hypotony) I had a trabeculectomy  and a revison to correct the low pressure. Pressure remains low in a range of 2 to 4 as it was prior to the revision. After each surgery I developed choroidal effusions. (Choroidals) Massive choroidals  had  almost entirely disappeared by the time of the revision, but smaller choroidals appeared after the  revision surgery and now have lingered  unchanged for over a year. (Choroidals lower pressures and low pressures cause choroidals in a vicious cycle.)My vision is a stable 20/25. I understand that at 73 low pressures may not be as harmful as in younger persons.  Three weeks ago my new  glaucoma specialist prescribed Atropine eye drops 1% twice a day to raise the pressures. I contacted my surgeon  who says Atropine will do no harm and no good. Both specialists are AGA members.(Fellowship training at Wills years ago.) My retina specialist does not think Atropine will help but "no harm in trying." Although  it is considered unlikely for  choroidals to go away at very low pressures, massive solid choroidals  which blocked peripheral vision  for a year  had largely  resolved  before the revison.Now smaller ones  do not budge but are "liquid" and clear and do not obstruct vision, but distort vision in the far periphery and cause light to flicker in certain light conditions. I am using the Atropine and will give it a good try. It does create problems of its own as it keep the pupil dilated.  The x is anti-spam.

Response:

Hi Betty: "Betty" <b…@xsan.rr.com> wrote: >Can anyone comment  about the use of Atropine eye drops to raise too low an >IOP?        <snip>

I passed your message along to Dr. Robert Ritch. He responded, "Yes. People use it if there are choroidal effusions. I use Hyoscine instead, which is more comfortable to the eye and just as effective and more easily reversible if necessary." Regards, Ray Bonar

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