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Management of Ophthalmic Injuries by the Forward Surgical Team
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Richard J. Blanch, Johno Breeze, William G. Gensheimer
Examine the size of both pupils in bright and dim conditions. They should be the same size. Pupil size differences may indicate ocular trauma (with iris sphincter damage); neurological damage (third nerve palsy is a false localising of elevated intracranial pressure and is accompanied by ptosis and eye movement abnormalities) or prior unilateral application of a mydriatic agent.
Vasoconstrictors: Chemistry, Mode of Action, and Dosage
Published in Marwali Harahap, Adel R. Abadir, Anesthesia and Analgesia in Dermatologic Surgery, 2019
Phenylephrine is available as a parenteral solution (1 mL of 1% solution), a nasal decongestant (0.1–5%) and mydriatic agent in the eyes (2.5–10%), and as oral decongestants (10). Outside of the United States, phenylephrine is used as a topical vasoconstrictor in rectal ointments, which consist of betamethasone valerate (0.05%), lidocaine (2.5%), and phenylephrine HCl (0.1%).
Anterior segment inflammation and its association with dry eye parameters following myopic SMILE and FS-LASIK
Published in Annals of Medicine, 2023
Jian Zhao, Yuan Li, Tianyun Yu, Wenhao Wang, Mutsvene Tinashe Emmanuel, Qianwen Gong, Liang Hu
Measurements were performed without any mydriatic agent at baseline and repeated after 1 day, 1 week, 1 month, and 3 months. On day 1, tests were performed after the removal of contact lenses. The laser flare photometer FM-600 (Kowa, Nagoya, Japan) was used to assess anterior chamber inflammation. Five consecutive readings from the lower third of the anterior chamber were recorded under dim ambient illumination. The background scatter should be less than 10%. After excluding the highest and lowest values, the average of the remaining readings was obtained. Keratograph 5 M (Oculus GmbH, Wetzlar, Germany) was used to assess bulbar redness (BR) and limbal redness (LR). Patients were instructed to keep their eyes wide open. Redness was graded from avascular (0) to severely hyperemic (4) based on the area percentage ratio between the vessels and the rest of the analyzed area [13].
Pupillary Dilation in Research: More than Meets the Eye
Published in Current Eye Research, 2022
Jacob Szpernal, Jane A. Bachman Groth, Niamh Wynne, Vesper Williams, Ryan Spellecy, Catherine Thuruthumaly, Joseph Carroll
To assist a researcher in properly screening individuals for low risk, we created a flowchart that can uncover individuals with the lowest-risk eyes (Figure 1). Individuals with the lowest risk include those without previous history of allergic reaction, those who are not pregnant or nursing, those without medical conditions and medications that may negatively interact with dilation agents, and those without concerning anterior segment anatomy that places them at increased risk for angle closure.3–6 Eyes with the lowest risk also include those that have had safe historic dilation. Therefore, we suggest that lower risk eyes can also include those that have been safely dilated within the past 6 months. The potential for complications between the concerning medical conditions and medications with dilating agents such phenylephrine, cyclopentolate, tropicamide, and atropine is shown in Table 1. This table can be used to aid a researcher through the prescreening flowchart for the lowest-risk eyes. Taking these factors into consideration will allow for the proper selection of a mydriatic agent for a given participant and their individual variables.
Proparacaine-Induced Mydriasis During Strabismus Surgery
Published in Seminars in Ophthalmology, 2018
Brijesh Takkar, Pradeep Sharma, Nripen Gaur, Ashutosh Kumar Singh, Rashmi Ramachandran
A possible fallout of PH is its effect on the pupil, whose dimensions are crucial to the surgeon, as discussed earlier. There have been multiple reports discussing the potentiating effect of topical anesthesia on tropicamide-induced mydriasis.6–9 In fact, this effect of PH has been utilized to advantage in children for optimizing refraction with cycloplegic agents.10 Although the exact reasons behind this synergistic effect are unknown, previous investigations have determined decreased tear production and corneal microepithelial damage as the cause of increased penetration of the mydriatic agent resulting in greater bioavailability.8,9 A 3-to 5-minute time interval between anesthetic agent and mydriatic agent may be suitable for this effect during outpatient use.8 However, none of these studies has evaluated the mydriatic effect of topical PH as monotherapy, possibly because of its limited effect on pupil dimensions.