Spiriva for COPD can theoretically cause angle closure glaucoma in narrow angle patients, but risk likely low.

There is 1 case report of Tiotropium (ingredient in SPIRIVA) causing acute angle closure glaucoma. If you have narrow angles of eye, let PCP know. Otherwise rare risk of cataract. No case reports of macular degeneration. 
 2007;20(6):627-8. Epub 2006 Aug 18.

Acute angle-closure glaucoma precipitated by local tiotropium absorption.


Acute angle-closure glaucoma is a rare form of glaucoma occurring when the filtration mechanism for the aqueous humor is obstructed by apposition of the peripheral iris to the trabecular meshwork. It may be precipitated by pupillary dilatation in a predisposed eye. In this case report, a possible relationship between local tiotropium absorption and acute angle-closure glaucoma attack is presented.
Drug insert reports rare cataract noted in a patient taking SPIRIVA, but no case reports in literature.
Likely patient had a lens change prior to using med.


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