Indications: chronic non-congestive glaucoma and to reverse mydriasis.

Cautions: A darkly pigmented iris may require higher concentration of the miotic or more frequent administration and care should be taken to avoid overdosage. Retinal detachment has occurred in susceptible individuals and those with retinal disease; therefore fundus examination is advised before starting treatment with a miotic. Care is also required in conjunctival or corneal damage. Intra-ocular pressure and visual fields should be monitored in those with chronic simple glaucoma and those receiving long-term treatment with a miotic. Miotics should be used with caution in cardiac disease, hypertension, asthma, peptic ulceration, urinary-tract obstruction, and Parkinson's disease. Blurred vision may affect performance of skilled tasks (e.g. driving) particularly at night or in reduced lighting.

Contra-indications: conditions where pupillary constriction is undesirable such as acute iritis, anterior uveitis and some forms of secondary glaucoma. They should be avoided in acute inflammatory disease of the anterior segment.

Side Effects: Ciliary spasm leads to headache and browache which may be more severe in the initial 2–4 weeks of treatment (a particular disadvantage in patients under 40 years of age). Ocular Side effects include burning, itching, smarting, blurred vision, conjunctival vascular congestion, myopia, lens changes with chronic use, vitreous haemorrhage, and pupillary block.

Dose: glaucoma, 1 drop 3-6 times daily; miosis, 1 drop of 1% solution.