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Medical Author:

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, FACS

Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr. Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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Miotics are eye drops that stimulate the parasympathetic nervous system causing the pupil of the eye to become smaller. They reduce intraocular pressure by increasing the outflow of eye fluids from the eye and they are usually used to reverse angle-closure glaucoma or prevent angle-closure in eyes with narrow chamber angles. Pilocarpine (one of the miotics) has been used for almost 150 years for the treatment of glaucoma. It is rarely utilized today to treat open-angle glaucoma.

Miotic drops include pilocarpine (Ocusert Pilo-40, Pilocar, Pilagan, Piloptic, Pilostat), carbachol (Carbastat, Carboptic, Isopto Carbachol, Miochol and Miostat Intraocular), and echothiophate iodide ophthalmic (Phospholine Iodide).

Who should not use these medications:

• Persons allergic to pilocarpine
• Persons with inflammation (swelling) of the eye

Drug or food interactions: If administered with prostaglandin eye drops, wait at least 10 minutes -- preferably, 1 hour -- between applying the two drugs.

Side effects: Miotics should be used with caution in persons with corneal abrasion(s) and in those with a history of retinal detachment.

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