Reduction of Human Intraocular Pressure with Intravenous Mannitol

Abstract

The reduction of intraocular pressure when this is acutely raised and prior to surgery is often essential. Osmotically acting urea has been used for this purpose during the past 2 years.^1-11 It is desirable that such therapy should be both effective and free from harmful and annoying side-effects to the patient. This has not been entirely the case with urea which can produce uncontrollable diuresis, headaches analogous to postlumbar puncture headaches, necrosis of soft tissue, nausea and vomiting, arm pain, confusion, hyperthermia, a shock-like state,² hypertension in labile hypertensives, thirst,⁷ and increase in blood volume with pulmonary edema.⁴ Hypertonic mannitol has been used to reduce intracranial pressures in animals and humans and would appear to be safe and effective for this purpose.¹³ The use of mannitol to reduce intraocular pressure was suggested to one of us by Dr. Shaffer on a recent visit to San