Hexamethonium and glaucoma.

THIS investigation was undertaken in an endeavour to decide if the methonium ganglion blocking compounds could be administered to cases of vascular hypertension who were known to be suffering from glaucoma, or to similar vascular hypertensive cases of a glaucomatous disposition although this might not be known, without the danger of subsequent sequelae such as an increase in intra-ocular pressure. The report by Ullman and Mossman (1950) of the occurrence of glaucoma in cases treated by the belladonna alkaloids administered orally, has raised the question as to whether or not similar dangerous side-effects might result from the administration of the alkamethonium ganglion-blocking agents in vascular hypertension. These authors state that the peripheral action of the alkaloids of belladonna is on the autonomic effector cells and not on nerve endings, producing in the eye (i) mydriasis, (ii) cycloplegia, and perhaps (iii) vasodilatation. This may elevate the intra-ocular pressure in the following way: