Drug Influences

In situations where it is clear there is a more serious cause for a red eye, it is important to take a thorough drug history. Many drugs can precipitate acute angle closure glaucoma in an already susceptible patient [4]. Some of the more common drugs include:

• Adrenergic agonists e.g. salbutamol
• Antidepressants – particularly selective serotonin reuptake inhibitors e.g. fluoxetine, citalopram
• Anticholinergics – hyoscine, atropine and ipratropium
• Antihistamines – those with a mild anticholinergic effect e.g. chlorphenamine

Learning bite

A number of commonly prescribed drugs may precipitate acute angle closure glaucoma as a result of either anticholinergic or adrenergic effects.