Systemic reaction to subconjunctival phenylephrine.

After a subconjunctival injection of phenylephrine, cocaine and atropine, a patient's blood pressure rose to 220/180 mmHg. This rise was followed by hypotension, pulmonary edema, and subendocardial ischemia, all of which resolved spontaneously within 12 hours. This report reemphasizes the hazardous effects on blood pressure of phenylephrine applied to the eye.