Cycloplegic Provocative Testing After Topical Administration of Steroids

Elevation of intraocular pressure after the topical application of cyloplegic, though rarely noted in the normal population, is seen in some 25% of the open angle glaucomatous population. No positive cycloplegic provocative responses were elicited from a population of 58 normals. After three weeks of treatment with topically administered dexamethasone, however, a 19% incidence of positive cycloplegic provocative tests was found in this same group. No correlation was noted between poststeroid intraocular pressure and cyloplegic-induced pressure elevation, but a statistically significant, inverse correlation between positive cycloplegic responses and outflow facility was noted after steroid treatment. The phenomenon of cycloplegic-induced pressure elevation thus appears to be related more closely to impaired outflow facility than to pretesting intraocular pressure levels.