Sea sickness patch

[reefduffer]

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Tame the Technicolor Yodel: Managing Mal de Mer
Doc Vikingo's Sea Sickness Remedies
Also:
Scopalamine—Pill (Scopace) vs Patch (Transderm Scop)
Doc Vikingo's Scopace Patch ...

Doc, thanks for the article. By pure coincidence (more about that below) I was reading the Wikipedia entry on Scopolamine this morning. Scopolamine - Wikipedia, the free encyclopedia and noticed this:
Adverse effects
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Use in scuba diving to prevent sea sickness has led to the discovery of another side effect. In deep water, below 50–60 feet, some divers have reported pain in the eyes that subsides quickly if the diver ascends to a depth of 40 feet or less. Mydriatics can precipitate an attack of glaucoma in susceptible patients, so the medication should be used with extra caution among divers who intend to go below 50 feet.

My wife sometimes uses the patch for boat diving, so that caught my attention. Your article didn't mention this, that I noticed. I also found no reference to it in the DAN discussion at DAN Divers Alert Network : Motion Sickness , which is apparently from 1995. Could you comment on the eye pain/glaucoma side effect at depth reported by Wikipedia?

As for why I was reading about Scopolamine, see this CNN story: Colombian drug strips users' free will - CNN.com
The Wikipedia article mentions this under "Criminal use and urban legends". I'm ... skeptical. I first thought the CNN story was an April Fools thing that got bounced around for a week, but maybe not. At any rate, the "zombie" dose seems to be higher than the seasickness dose, so that's not directly an issue. I'm still both skeptical and curious about this use. Just an aside.

The real question here is the scuba eye pain side effect mentioned in the Wikipedia article.

 

[Bubbletrubble]

@reefduffer: You'd probably be interested in learning a little about the two main forms of glaucoma.

First of all, you need to know that doctors really don't know what causes glaucoma. It is thought that a buildup of the aqueous humor (fluid naturally/continuously produced in the front of the eye) causes a pathological increase in intraocular pressure, which then damages the optic nerve. Aqueous humor normally exits the eye through a drainage system located at the junction of the iris and cornea. When this drainage system gets blocked up, intraocular pressure builds.

The two most common forms of glaucoma are open-angle and closed-angle:

• Open-angle glaucoma occurs when the drainage angle between the iris and cornea remains open but the teeny-tiny channels in the angle (trabecular meshwork) become partially obstructed. With aqueous humor leaving the eye at a slower rate, this causes intraocular pressure to build. This usually leads to slow, progressive damage to the optic nerve.
• Closed-angle glaucoma occurs when the iris bulges forward to block the drainage angle completely or partially. Once again, this causes intraocular pressure to build. Closed-angle glaucoma can have a rapid (acute) or gradual (chronic) onset.

So how does this all relate to scopolamine and other mydriatic drugs? This class of drugs causes pupillary dilation. It's possible for this pupillary dilation to partially or completely block drainage of the aqueous humor in the eye. The resulting effect is an acute closed-angle glaucoma.

Will such a short-lived effect cause long-lasting damage to the optic nerve of a diver? Unlikely. But if a diver who is taking scopolamine for seasickness senses eye pain above or below the water, it would probably be best for him to stop taking that med.

 

[wrecker007]

You may want to look at the pill form of this drug. It's called scopace. It is a prescription drug & works better than the patch for a one good reason. You control the dosage. The patch can deliver greater amounts of the drug at depth which can have weird side effects. If the full dosage in the pill format seems too much (my own problem) you can cut the pill in half & take that instead. That amount works for me. Hope you have a great dive trip...