Phospholine iodide (echothiophate), a long-acting anticholinesterase, is used in paediatric accommodative esotropia. Its MAJOR ocular side effect with prolonged use is:
- A Anterior subcapsular lens opacities ✓
- B Raised intraocular pressure
- C Corneal neovascularisation
- D Retinal pigmentary degeneration
Correct answer: A. Anterior subcapsular lens opacities
Explanation
Echothiophate iodide, a long-acting irreversible cholinesterase inhibitor, causes anterior subcapsular (nuclear) lens opacities with chronic use due to accumulation of acetylcholine-related metabolites affecting lens epithelial cells. This is a well-recognised side effect that may require discontinuation. It also depletes pseudocholinesterase, causing prolonged apnoea with succinylcholine if general anaesthesia is administered. Raised IOP is not a typical side effect of miotics.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.