Hazards of the Use of Sympathomimetic Drugs in Ophthalmology

Abstract

Sympathomimetic drugs such as epinephrine (Adrenalin), phenylephrine (Neo-Synephrine), and hydroxyamphetamine (Paredrine) have attained widespread popularity among ophthalmologists. Their effects of mydriasis and vasoconstriction are useful in refraction, in ophthalmoscopic examination, in the therapy of conjunctivitis and of uveitis, and in control of surgical bleeding. Also, because of their prolonged hypotensive effect, sympathomimetic-miotic combinations have been used in the therapy of wide-angle glaucoma. Thus, the importance of the sympathomimetic drugs, both diagnostically and therapeutically, is well recognized. However, ophthalmologists generally regard this important group of drugs as harmless, except for the possibility of precipitating acute narrow-angle glaucoma. We, therefore, feel it worth while to present a case of acute subarachnoid hemorrhage resulting from the use of phenylephrine and to discuss other reported hazards of the sympathomimetic drugs. Report of a Case A 35-year-old white man had been treated two weeks for an acute iritis O. S. by one of us (J.