What condition might Pilocarpine treat during an emergency?

Pilocarpine is a potent miotic agent that works by stimulating the parasympathetic nervous system, leading to the contraction of the iris sphincter muscle, which in turn causes miosis (constriction of the pupil). In the context of an acute angle closure attack, where the angle between the iris and cornea suddenly becomes narrowed or closed, glaucomatous symptoms can rapidly develop due to increased intraocular pressure.

By constricting the pupil, pilocarpine facilitates better drainage of aqueous humor through the trabecular meshwork, which can help lower intraocular pressure in this emergency situation. The reduction in pupil size also helps to open up the angle slightly, allowing for improved outflow of the aqueous humor. This mechanism makes pilocarpine an effective immediate treatment in acute angle closure glaucoma.

In contrast, other conditions listed such as cataract crisis, open-angle glaucoma, and chronic inflammatory glaucoma do not represent immediate emergencies that require the rapid action of pilocarpine. Open-angle glaucoma, for example, is generally managed with long-term medications and is not characterized by the same acute scenario as angle closure. Overall, pilocarpine is specifically utilized for its acute effects on the pupil and intraocular pressure