Evaluating the Potentiating Effect of Amethocaine on Tropicamide-Induced Mydriasis in Darkly Pigmented Irides, Using Infrared Pupillometry

Ogun, Olufunmilola; Oliver, Jeffrey W.; Ashaye, Adeyinka; Ajayi, Benedictus G K

doi:10.4137/oed.s13991

Cited by 8 publications

(6 citation statements)

References 19 publications

(39 reference statements)

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“…Atypical dark skinned Nigerian patients has densely pigmented iris. This increased pigmentation in iris produces a difference in the pupillary diameter in a Nigerian subject as compared to ours [20]. Emiru suggested the same theory, which states that for poor pupillary dilation it is the iris pigmentation which is more likely to be responsible than the race.…”

Section: Discussionsupporting

confidence: 60%

“…Chen and Poth also could explain that there is decreased drug absorption in iris crypts due to obstruction of pigments within the chromophores which leads to the decreased mydriatic effect [22,23]. The rate of corneal epithelial cell migration is inhibited by topical anesthetics by disrupting the cytoplasmic action in filaments that destroy superficial corneal epithelial microvilli [20]. The proparacaine has potentiating effect on the tropicamide induced pupillary dilation.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Topical Proparacaine 0.5% on Tropicamide- Induced Mydriasis

Singh

2020

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Purpose: The topical anesthetic proparacaine (0.5%) is recommended to enhance the rate and magnitude of pupillary dilatation if it is instilled before mydriatic tropicamide. However there is scarcity of data supporting this. Therefore we conducted a study to analyze if preinstillation of topical proparacaine (0.5%) can potentiate the mydriatic efficacy of 0.8% tropicamide. Methods: The patients were divided into two groups for pupillary dilatation. The study group was given a drop 0.5% proparacaine before instilling one drop of tropicamide while the control group was given the tropicamide alone. The pupillary size was measured and recorded before the instillation of tropicamide at 0 min, 15 min, 30 min. The end point was taken as 6 mm pupillary size (clinically effective diameter). Results: There was a statistically significant difference in rate of pupillary diameter between the control and the study group. The rate of pupillary dilatation at 15min and 30 min was statistically significantly different between the control and study group. Conclusion: The study concluded that prior instillation of topical proparacaine produced a statistically significant difference in the rate of pupillary dilatation at 30 mins. Therefore, we suggest the use of a topical anesthetic before tropicamide induced mydriasis.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Effect of Topical Proparacaine 0.5% on Tropicamide- Induced Mydriasis

Singh

2020

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“…The difference in the pupillary diameter may be because of the increased pigmentation in a Nigerian subject as compared to ours. 17 Same theory was suggested by Emiru, who states that iris pigmentation and not the race that is more likely to be responsible for the poorer pupil dilatation. Emiru noted that the dark-skinned African did not achieve the large pupil diameters even after 60 mins of dilatation.…”

Section: Discussionmentioning

confidence: 98%

A quasi-experimental study to assess the effect of a local anesthetic proparacaine on tropicamide-induced pupillary dilation

Menishinkai

Pujar

Manasa

et al. 2015

Int J Basic Clin Pharmacol

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“…Dark eyes do not dilate as fast or as well as light-colored eyes, but the effect lasts longer. 21 The effect of atropine on pupil size is observed when eye drops are used even in low dose solutions (0.01% and 0.005%, whereas as a mydriatic is being used in concentration of 1%). 22 Evidence regarding intravenous atropine use in narrow angle glaucoma is conflicting.…”

Section: Discussionmentioning

confidence: 99%

The effect of atropine used in dobutamine stress echocardiography on pupil diameter

Soulis

Papaioannou

Zozolou

et al. 2022

European Journal of Ophthalmology

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Background The use of atropine during dobutamine stress echocardiography (DSE) is contraindicated in persons with narrow angle glaucoma though there is limited evidence that low doses of intravenous atropine do not cause pupillary dilation. Objective The aim of this study is to investigate whether atropine when administered in persons without glaucoma during dobutamine stress echocardiography causes pupillary dilation. Methods and Results Out of 144 patients without a history of glaucoma referred for DSE for clinical indications, 105 patients received intravenous atropine doses ranging from 0.1 mg to 1.25 mg (most patients received 0.25–0.75 mg). Pupil diameter of both eyes was measured under the same light conditions before and after the DSE using a CP-30 Optical Digital PD Ruler. For the total of 210 examined eyes pupil diameter remained unaltered after each DSE test (3.65 ± 0.799 mm before vs 3.63 ± 0.766 mm after, p = .737). Similarly, pupil diameter remained unchanged when left and right eyes were assessed separately (right eye: 3.770 ± 0.812 before vs 3.752 ± 0.745 mm after, p = .821 and left eye: 3.521 ± 0.770 before vs 3.499 ± 0.770 mm after, p = .806). Diameter of right and left pupil were also unaltered after grouping patients by sex and iris pigmentation. Age, weight, atropine dose and propranolol dose were not correlated with changes in pupil diameter. Conclusion Intravenous atropine in usual doses administered in DSE does not cause mydriasis in adults without glaucoma. Future studies need to confirm our findings and expand the investigation regarding safety of atropine use during DSE in patients with narrow angle glaucoma.

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Evaluating the Potentiating Effect of Amethocaine on Tropicamide-Induced Mydriasis in Darkly Pigmented Irides, Using Infrared Pupillometry

Cited by 8 publications

References 19 publications

Effect of Topical Proparacaine 0.5% on Tropicamide- Induced Mydriasis

Effect of Topical Proparacaine 0.5% on Tropicamide- Induced Mydriasis

A quasi-experimental study to assess the effect of a local anesthetic proparacaine on tropicamide-induced pupillary dilation

The effect of atropine used in dobutamine stress echocardiography on pupil diameter

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