Certified Ophthalmic Medical Technologist (COMT) Practice Exam

Miotics may lead to retinal detachment through what mechanism of action?

1. Inhibition of aqueous humor production

2. Contracture of the ciliary muscle

3. Dilation of the pupil

4. Increasing intraocular pressure

The correct answer is: Contracture of the ciliary muscle

Miotics work primarily by causing the contraction of the iris sphincter muscle, which consequently leads to contraction of the ciliary muscle. This action is essential in facilitating the accommodation process but can also have an unintended consequence: it increases tension on the vitreous body, which is attached to the retina. This increased tension can lead to the pulling away of the retina from its normal position, thereby increasing the risk of retinal detachment. In contrast, other mechanisms mentioned do not directly relate to the risk of retinal detachment. Inhibition of aqueous humor production and increasing intraocular pressure are primarily associated with glaucoma management and are not directly linked to retinal detachment. Dilation of the pupil is counterproductive in the context of miotics, as miotics actually constrict the pupil instead. Understanding the specific action of miotics on the ciliary muscle is crucial in recognizing how these medications can inadvertently lead to complications like retinal detachment.