RecommendationWhen an adequate view of the optic nerve head and surrounding area is unavailable at a monitoring visit, people undergoing stereoscopic slit lamp biomicroscopy should have their pupils dilated before the assessment.
Trade off between clinical benefits and harmsSmall pupil size may exclude a stereoscopic view of the optic disc thereby preventing adequate assessment. Pupil dilatation in the presence of open angles carries low risk provided there are no specific contraindications to dilatation (e.g. iris supported implants).
Economic considerationsDilatation increases the cost of the assessment in terms of the cost of drops and clinician’s time taken.
Other considerationsPatient views. Patients should be alerted to possible consequences of having their pupils dilated. Dilatation for optic disc examination may affect a patient’s ability to drive afterwards. Obtaining accurate information outweighs the minor inconvenience caused by pupil dilatation.

From: 5, Monitoring of patients with ocular hypertension, chronic open angle glaucoma and suspected chronic open angle glaucoma

Cover of Glaucoma
Glaucoma: Diagnosis and Management of Chronic Open Angle Glaucoma and Ocular Hypertension.
NICE Clinical Guidelines, No. 85.
National Collaborating Centre for Acute Care (UK).
Copyright © 2009, National Collaborating Centre for Acute Care.

Apart from any fair dealing for the purposes of research or private study, criticism or review, as permitted under the Copyright, Designs and Patents Act, 1988, no part of this publication may be reproduced, stored or transmitted in any form or by any means, without the prior written permission of the publisher or, in the case of reprographic reproduction, in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publisher at the UK address printed on this page.

The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore for general use.

The rights of National Collaborating Centre for Acute Care to be identified as Author of this work have been asserted by them in accordance with the Copyright, Designs and Patents Act, 1988.

PubMed Health. A service of the National Library of Medicine, National Institutes of Health.