Anticholinesterase Agents. Echothiophate is a long-acting anticholinesterase miotic that decreases IOP and prolongs the duration of action of SCh.
Cyclopentolate is a mydriatic agent and may produce central nervous system toxicity.
Epinephrine as a topical has proved useful in some patients with open-angle glaucoma, but systemic side effects may occur. The prodrug of epinephrine, dipivefrin, produces similar ocular benefits (reduces aqueous productions and augments outflow) with fewer side effects.
Phenylephrine is a mydriatic agent that may produce cardiovascular effects.
Timolol lowers IOP, but systemic absorption may result in cardiac depression and increased airway resistance. Betaxolol may be more oculo specific and has minimal systemic effects.
Sulfur hexafluoride (SF6) is injected into the vitreous to mechanically facilitate retinal reattachment. Nitrous oxide (N2O) (blood/gas solubility 0.47) should be avoided for 10 days after intravitreous injection of SF6 (blood/gas solubility 0.004). A Medic-Alert bracelet might be helpful to warn against administration of N2O during the period when this gas could cause expansion of the SF6 bubble, risking optic nerve ischemia secondary to central retinal artery occlusion.