Ocular effects of scopolamine dermal patch in open-angle glaucoma.

The purpose of this study was to determine the effect of transdermal scopolamine patches on intraocular pressure, pupil size, anterior chamber volume, and accommodation in patients with open-angle glaucoma. Forty patients with chronic open-angle glaucoma participated in a double-masked randomized, placebo-controlled study. Of these 40 glaucoma patients, 20 were on treatment regimens that included pilocarpine (Pilo Group) and 20 were on treatment regimens that excluded pilocarpine or any other cholinergic drug (Non-Pilo Group). For both groups, there was a significant increase in pupil size, anterior chamber volume, and near point on the scopolamine day compared to the placebo day. The pupil size, as measured by pupillography, was increased 17% for the Pilo group and increased 12% for the Non-Pilo group. The volume of the anterior chamber, as measured by photograrmmetry, was increased 8% for the Pilo group and increased 11% for the Non-Pilo group. The near point receded 12% for the Pilo group and receded 19% for the Non-Pilo group. We were unable to detect any statistically significant differences in intraocular pressure for either group. Minimal side effects were reported from both groups. We conclude that it is safe for patients with open-angle glaucoma to use transdermal scopolamine patches.