Cholinergic miotic (intra-ocular)
Acetylcholine chloride
Brand names: Miochol-E
Adult dose
Dose: 0.5–2 mL of 1% solution intra-ocularly
Route: Intra-ocular irrigation
Frequency: Single use during surgery
Clinical pearls
- Used for rapid miosis after lens delivery in cataract/anterior segment surgery
- Reconstitute immediately before use
Contraindications
- Hypersensitivity
Side effects
- Corneal oedema
- Bradycardia
- Hypotension (systemic absorption)
Interactions
- Topical NSAIDs may blunt miosis
Monitoring
- Intra-operative HR/BP if leakage
Reference: BNF; RCOphth Cataract Surgery Guidelines 2018; SmPC Miochol-E. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- IABP Timing Assessment · Mechanical Circulatory Support
- Myasthenia Gravis Activities of Daily Living (MG-ADL) Scale · Neuromuscular
- Intraocular Pressure Stratification & Glaucoma Risk · Glaucoma
- Roper-Hall Classification of Chemical Ocular Burns · Ocular Trauma
- Dua Classification of Chemical Ocular Injuries · Ocular Trauma
- Traumatic Hyphaema Grading · Ocular Trauma
Pathways
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme