EFFECT OF NEBULIZED IPRATROPIUM BROMIDE ON INTRAOCULAR PRESSURES IN CHILDREN

Study objective: To evaluate the effects of nebulized ipratropium brom ide on intraocular pressures and pupillary responses in children with asthma. Design: A double-blind, randomized, crossover study. Setting: Children's Hospital of Winnipeg, University of Manitoba. Patients or p articipants: Age 6 to 17 years with asthma. Intervention: Nebulized ip ratropium bromide added to albuterol sulfate, albuterol alone, or sali ne solution was given by face mask and nebulizer. Before and 0.5 h aft er nebulization, intraocular pressures (mm Hg), pupillary size (mm), a nd pupillary responses were measured. In a subsequent open study, pati ents who had been admitted to hospital with acute asthma who were trea ted with nebulized ipratropium bromide were recruited for measurement of intraocular pressures, pupillary size, and pupillary responses. Mea surements and results: Twenty patients completed the double-blind stud y, and 26 patients completed the open study. There were no changes in intraocular pressures, pupillary size, or pupillary response after any treatment on any study day in either the double-blind or the open stu dies. Conclusion: In children with asthma, who have no preexisting ocu lar abnormalities, the risk of an adverse reaction to nebulized ipratr opium bromide delivered by face mask inadvertently absorbed in the eye is extremely small.