A Study of Mydriasis Produced by Topical Phenylephrine 2.5% in Young Adults
DOI :
https://doi.org/10.65636/cjo.v50i1.6947Mots-clés :
mydriasis, young adults, phenylephrineRésumé
In 1936, Heath suggested that topically instilled phenylephrine would be useful to dilate the pupil to allow examination of the fund us 1. He noted that the "mydriatic effect is substantial with the 1 % solution . . . the effect is noted in approximately 10 minutes and lasts a variable length of time following a single instiUation." Since that time there have been some 30 other studies concerning the effect of phenylephrine eyedrops on pupil size. Many of these studies provide some details of both the time course of the pupillary dilation along with details of the magnitude of the mydriasis obtained after periods of 60 to 90 min. Despite such an apparent wealth of studies2-33, an objective analysis of the data reported reveals that very little information is actually available on the concentration of phenylephrine (i.e. 2.5 %) that is most commonly indicated as a mydriatic in routine ocular examination (as opposed to surgical procedures). a mydriatic in routine ocular examination (as opposed to surgical procedures). In addition, there is considerable variance between the studies with respect to the magnitude of the mydriasis obtained (see Table I). Most studies report on only a few eyes (4 to 15) while those studies that report on large numbers of eyes either use a concentration of phenylephrine that is not routinely available for clinical use (i.e. 0.25%, 1%, 2%, 3% or 4%4,9.11.11,1s), employ a drop size that is not used clinically (i.e 5µ1, 32µ1 or 20µ) 12,19,24), or use multiple drops (or the number of drops is not specified)3,6.8.9,16.11,2s.26.32.
Références
1. Heath P. Neosynephrine HCI. Some uses and effects in ophthalmology. Arch Ophrhalmol 1936; 16: 839-846.
3. Feldman J.B. Mydriatics. A clinical observation. Arch OpJuhalmol 1949; 41; 42-59.
4. Barbee R.F., Smith W.O. A comparative study of mydriatic and cycloplegic agents in human subjects without eye disease. Am J Ophthalmol 1957; 44; 617-622.
5. Boberg-Ans, J., Grove-Rasmussen, K.Y., Hammarlund, E.R. Buffering technique for obtaining increased physiological response from alkaloidal eyedrops. Br J Ophthalmol 1959; 43: 670-675.
6. Gambill H.D., Ogle K.N., Kearns T.P. Mydriatic effect of four drugs determined with pupillograph. Arch Ophthalmol 1967; 77: 740-746.
7. Mapstone R. Safe mydriasis. Br J Ophthalmol 1970; 54: 690-692.
8. Haddad N.J., Moyer N.J., Riley F.C. Mydriatic effect of phenylephrine hydrochloride. Am J Ophtha/1110/ 1970; 70: 729-733.
9. Emiru Y.P. Response to mydraitics in the African. Br J Ophthalmol 1971; 55: 538-543.
10. Borthne A., Davanger M. Mydriatics and age. Acta Ophthalmol 1971; 49: 380-387.
11. Hertler, A., Smith, S.E. Genetic influences in drug response of the eye and the heart. Clin Sci 1971; 40: 403-410.
12. Smith S.E. Mydriatic drugs for routine fundal inspection. A reappraisal. The Lancet 1971; ii: 837-839.
13. Jauregui M.J., Poise K.A. Mydriatic effect using phenylephrine and proparacaine. Am J Optom Physiol Opt 1974; 51: 545-549.
14. Kubo D.J., Wing J.W., Poise K.A., Jauregui M.J. Mydriatic effects using low concentrations of phenylephrine hydrochloride. J Am Optom Assoc 1975; 46:817-822.
15. Korczyn, A.D., Laor N., Nemet P. Sympathetic pupillary tone in old age. Arch Ophthalmol 1976; 94: 1905-1906.
16. Smith R.B., Read S., Oczpok P.M. Mydriatic effect of phenylephrine. Eye F.ar Nose & 17iroat Monthly 1976; 55:
133-134.
17. Levine L. Effective degree of mydriasis with phenylephrine and tropicamide. Am J Optom Physiol Opt 1977; 53: 774-785.
18. Lyle W.M., Bobier W.R. Effects of topical anesthetics on phenylephrine-induced mydriasis. Am J. Optom Physiol Opt 1977; 54: 276-281.
19. Hendrickson R.O., Hanna C. Use of drugs in ointment form for routine mydriasis. Ann Ophtha/1110/ (Chic) 1977; 9: 333-336.
20. Laor, N., Korczyn, A.O. Sympathetic pupillary activity in Jewis ethnic groups. The Moum Sinai J Med 1979; 46: 411-412.
21. Neuhaus R.W. Helper R.S. Mydriatic effect of phenylephrine 10% (aq) vs phenylephrine 2.5% (aq). Ann Ophthalmo/ (Chic) 1980; 12: Ll59-1160.
22. Salminen, L., Aaltonen, H., Jantti, V. Mydriatic effect of low dose phenylephrine. Ophthal Res 1980; 12: 235-239.
23. O'Connor Davies P.H. The Actions and Uses of Ophthalmic Drugs. 2nd ed. London; Barrie & Jenkins, 1982; pp. 141-147.
24. Matsumoto S., Tsuru T., Araie M., Komuro Y. Pham1acokinetics of topical phenylephrine hydrochloride in the normal human eye. Jpn J Ophtha/1110/ 1982; 26: 338-344.
25. Duffin R.M., Pettit T.H., Straatsma B.R. 2.5% v 10% phenylephrine in maintaining mydriasis during cataract surgery. Arch Ophthalmol 1983; 101: 1903-1906.
26. Levine L. Minimizing risk of adverse reactions to mydriatic agents in binocular indirect ophthalmoscopy. J Am Oprom Assoc 1985; 56: 542-548.
27. Ward P.A., Charman W.N. Measurements of cycloplegia and mydriasis induced by three common ophthalmic drugs. Clin Exptl Optom 1986; 69: 62-70.
28. Mordi J.A., Lyle W.M., Mousa G.Y. Effect of phenylephrine on accommodation. Am J. Optom Physiol Opt 1986; 63:294-297.
29. Folk J.C.. Kumar V., Piper J.G., Barcellos W. A., Schoenwald R.D., Chien D-S.S. Aqueous vs viscous phenylphrine. 11. Mydriatic effects. Arch Ophthalmol 1986; 104: ll92-Ll93.
30. Ramsay D.A. Dilute solutions of phenylephrine and pilocarpine in the diagnosis of disordered autonomic innervation of the iris. J Neurol Sci 1986; 73: 125-134.
31. Ward P.A. Effects of common cycloplegic and mydriatic drugs. Optician 1986; 191: 12-15.
32. Mordi J., Tucker J., Charman W.N. Effects of 0.1% cyclopentolate or 10%phenylephrine on pupil diameter and accommodation. Ophthal Physiol Opt 1986; 6: 221-227.
33. Buckley C., Curtin D. M., Docherty J., Eustace P. Ageing and alpha1 adrenoceptors in the iris. Eye 1987; l: 211-216.
34. Bartlett J.D. Pupillary dilation. In: Clinical Ocular Pharmacology (Bartlett J. D., Jaanus S. D., eds). 1984 Butterwonh Publishers, Toronto. pp. 435.
35. Van Herick W., Schaffer R. N., Schwartz A. Estimation of width of angle of anterior chamber. Incidence and significance of the normal angle. Am J Ophthalmol 1969; 68: 626-629.
36. Cogan D.G. A simplified entoptic pupillometer. Am J Ophthalmol 1941; 24: 1431-1433.
37. Duke-Elder S. (ed). System of Ophthalmology. Vol. 5. Ophthalmic Optics and Refraction. London; Kimpton, 1970; pp 140.
38. Woo G.C.S., Long W.F. Recommended light levels for clinical procedures. Optometric Monthly 1979;
39. Grosvenor T. P. Primary Care Optometry. Chicago; The Professional Press. 1982, pp. 105.
40. Herman C.L. A FDA survey of U.S. contact lens wearers. Comact Lens Spectrum 1987; 2: 89-92.
Publié-e
Comment citer
Numéro
Rubrique
Licence
© M.J. Doughty, W. Lyle, R. Trevino, J. Flanagan 2026
Cette œuvre est sous licence Creative Commons Attribution - Pas d'Utilisation Commerciale - Pas de Modification 4.0 International.
