Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “CYCLOPLEGICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources
PubMed1975

Variations in refractive change induced by Cyclogyl upon children with differing degrees of ametropia.

The effect of cycloplegic drugs on refraction is complicated by the presence of many variables. This study is concerned with one of these: the type and degree of refractive error. A manifest and a cycloplegic refraction were performed on 170 eyes. The difference was determined in each case and tabulated according to the type of ametropia. This experiment showed that in every instance the cycloplegic estimate was equal to or greater in hyperopia or less in myopia than when performed without drugs. The greatest difference occurred in hyperopia, decreasing to zero once myopia was reached.

Accommodation, Ocular↗
PubMed1981

Dose-response effects of tropicamide HCl.

Using double-masking procedures, the mydriatic and cycloplegic effects of 0.25, 0.5, 0.75, and 1.0% tropicamide were studied. All doses produced clinically useful mydriasis of at least 6-mm pupils. Using testing conditions of both normal (35 ft-c) and bright (150 ft-c) illumination, no mydriatic dose-response differences for the four concentrations were found. Cycloplegic effects were dose related. A single drop of either 0.75 or 1.0% tropicamide reduced the amplitude of accommodation to about 1.5 D, which is adequate for a cycloplegic refraction.

Adult↗
PubMed1993

Dark focus of accommodation and uncorrected visual acuity.

We compared the dark focus of accommodation in 33 healthy children, 19 eyes with good uncorrected visual acuity (1.0 or more) vs. 14 with poor uncorrected visual acuity (below 1.0). The two groups were matched for age and cycloplegic refractive error. Cycloplegic refractive error ranged from +0.15 to +1.75 D in the good visual acuity group and from +0.25 to +1.87 D in the poor visual acuity group. The dark focus was defined as the difference between the refractive error in the dark and the refractive error under cycloplegia. Initially, visual acuity was measured subjectively. Next, refractive error in the dark was measured using the Nidek Autorefractometer AR1600 with its optical target light off. Refractive error under cycloplegia was measured 40 min after the instillation of cyclopentolate hydrochloride using the same autorefractometer. There was a significant correlation between the dark focus and the cycloplegic refractive error (r = -0.53, p < 0.01). Despite an equal refractive error under cycloplegia the dark focus was significantly larger in the eyes with good uncorrected visual acuity than in those with poor uncorrected visual acuity (p < 0.01). Tonic accommodation may influence uncorrected visual acuity.

Accommodation, Ocular↗
PubMed1994

Asthenopia and the dark focus of accommodation.

To study asthenopia, we compared the dark focus of accommodation of 54 symptomatic and 56 asymptomatic control subjects. The two groups were matched for age and cycloplegic refractive error. Symptomatic subjects were defined as those who complained of asthenopia daily even though their refractive error had been corrected. Subjects with other eye diseases that could produce asthenopia such as strabismus or aniseikonia were excluded. Using a Nidek Autorefractometer AR1600, we first measured non-cycloplegic refractive error (Non-Cyclo R) in a bright room, then the dark refractive state (Dark R) in complete darkness using the instrument with the optical target light extinguished and, finally, determined the cycloplegic refractive error (Cyclo R) after instilling cyclopentolate hydrochloride. The difference between Dark R and Cyclo R was defined as DFcus (Cyclo R) and that between Dark R and Non-Cyclo R as DFcus (Non-Cyclo R). We found both DFcus (Cyclo R) and DFcus (Non-Cyclo R) to be smaller in the symptomatic than in the asymptomatic subjects, indicating that asthenopia is associated with a low rather than a high level of tonic accommodation.

Accommodation, Ocular↗
PubMed2001

Retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%.

PURPOSE: This study compares retinoscopy in infants using a near noncycloplegic technique, cycloplegia with tropicamide 1%, and cycloplegia with cyclopentolate 1%. The study sample included 29 healthy, nonstrabismic infants 4 to 7 months of age (mean 5.71 months). METHODS: Each study subject was examined at two separate visits an average of 2 weeks apart (mean [+/-SD] 14 +/- 9 days). The examiner completed a case history, iris color grading, confrontation tests, and noncycloplegic near retinoscopy in a dark room and then instilled a drop of topical anesthetic in each eye followed by 2 drops of cycloplegic agent separated by 5 min. Retinoscopy was performed 25 to 30 min after the first drops were instilled. The bottles were masked, and the drop administered at the first visit was randomly assigned. RESULTS: On a scale of 0 to 4.9, the median iris grade was 4.0, which corresponds to a brown or darkly pigmented iris. All reported retinoscopy results are for the horizontal meridian of the right eye. The mean refractive error using noncycloplegic near retinoscopy was +0.94 D (+/-1.19 D). The mean refractive error was +1.81 D (+/-1.19 D) with tropicamide and +1.88 D (+/-1.45 D) with cyclopentolate. There was no statistically or clinically significant difference between the two cycloplegic measurements using different diagnostic agents (t = -0.46, p = 0.65). The mean difference between noncycloplegic and cycloplegic retinoscopy was 0.89 D (+/-0.66 D) with tropicamide (t = -6.57, p < 0.0001) and 1.04 D (+/-0.94 D) with cyclopentolate (t = -5.38, p < 0.0001; all two-sided paired t-tests). There were no serious adverse reactions with either agent, although one infant temporarily developed redder than normal cheeks after instillation of cyclopentolate. CONCLUSION: Our results suggest that tropicamide is as effective as cyclopentolate for the measurement of refractive error in most healthy, nonstrabismic infants.

Ciliary Body↗
PubMed2006

The Study of Progression of Adult Nearsightedness (SPAN): design and baseline characteristics.

PURPOSE: The Study of Progression of Adult Nearsightedness (SPAN) is a 5-year observational study to determine the risk factors associated with adult myopia progression. Candidate risk factors include: a high proportion of time spent performing near tasks, performing near tasks at a close distance, high accommodative convergence/accommodation (AC/A) ratio, and high accommodative lag. METHODS: Subjects between 25 and 35 years of age, with at least -0.50 D spherical equivalent of myopia (cycloplegic autorefraction), were recruited from the faculty and staff of The Ohio State University. Progression is defined as an increase in myopia of at least -0.75 D spherical equivalent as determined by cycloplegic autorefraction. Annual testing includes visual acuity, noncycloplegic autorefraction and autokeratometry, phoria, accommodative lag, response AC/A ratio, cycloplegic autorefraction, videophakometry, ultrasound, and partial coherence interferometry (IOLMaster). Participants' near activities were assessed using the experience sampling method (ESM). Subjects carried a pager for two 1-week periods and were paged randomly throughout the day. Each time they were paged, they dialed into an automated telephone survey and reported their visual activity at that time. From these responses, the proportion of time spent performing near work was estimated. RESULTS: Three-hundred ninety-six subjects were enrolled in SPAN. The mean (+/- standard deviation) age at baseline was 30.7 +/- 3.5 years, 66% were female, 80% were white, 11% were black, and 8% were Asian/Pacific Islander. The mean level of myopia (spherical equivalent) was -3.54 +/- 1.77 D, the mean axial length by IOLMaster was 24.6 +/- 1.1 mm, and subjects were 1.7 +/- 4.0 Delta exophoric. Refractive error was associated with the number of myopic parents (F = 3.83, p = 0.023), and the number of myopic parents was associated with the age of myopia onset (chi2 = 13.78, p = 0.001). In a multivariate analysis, onset of myopia (early vs. late) still had a significant effect on degree of myopia (F = 115.1, p < 0.001), but the number of myopic parents was no longer significant (F = 0.65, p = 0.52). For the ESM, the most frequently reported visual task was computer use (mean, 18.9%; range, 0-60.0%) and, overall, subjects reported near work activity 34.1% of the time (range, 0-67.3%). CONCLUSIONS: The design of SPAN and the baseline characteristics of the cohort have been described. Parental history of myopia is related to the degree of myopia at baseline, but this effect is mediated by the age of onset of myopia.

Accommodation, Ocular↗
PubMed1994

Screening of infants for significant refractive error using videorefraction.

Isotropic photorefraction has been suggested as a suitable method for screening infants for refractive error. Recently published data suggested that reasonable consistency with retinoscopy results might be achieved using cycloplegic videophotorefraction (VPR) for spherical refractive error but that results might be unreliable for astigmatic errors. Non-cycloplegic VPR did not appear to produce results consistent with retinoscopy. A practical idea of how many children might be identified using this technique and how many missed was needed by personnel designing screening projects. Hence the VPR was tested by screening a population of 247 infants for significant refractive error, and comparing the results with cycloplegic retinoscopy. Sensitivity and specificity scores were calculated for a range of test levels of ametropia. Without cycloplegia, sensitivity of VPR was poor. With cycloplegia the situation was much improved, with sensitivity for hyperopia +4.00 D or over of 83.3% and specificity of 90.6%. Sensitivity for astigmatism of 1 D or greater (84.6%) was high but specificity was poor (45.6%). Acceptable sensitivity was achieved for identifying children in this age group at risk of developing squint and amblyopia due to refractive error, providing cycloplegia was used.

Amblyopia↗
PubMed1993

Dark focus of accommodation in children with accommodative esotropia and hyperopic anisometropia.

We evaluated the dark focus of accommodation, referred to as tonic accommodation, in 60 young hyperopic subjects, 20 with and 20 without accommodative esotropia, and 20 with hyperopic anisometropia. We measured the distance, dark, and cycloplegic refractive errors by the Nidek Autorefractometer AR1600. The difference between dark and cycloplegic refractive errors was defined as the dark focus. The dark focus was significantly larger in esotropic eyes than in non-esotropic eyes, despite similar cycloplegic refractive errors in both types of eyes, suggesting that tonic accommodation may be associated with ocular position. The dark focus was similar in eyes of the same subjects with hyperopic anisometropia and also in normal and amblyopic eyes, suggesting that tonic accommodation is similar in both eyes in subjects with anisometropia and amblyopia.

Accommodation, Ocular↗
PubMedDate not supplied

Topical aminocaproic acid to prevent rebleeding in cases of traumatic hyphema.

PURPOSE: To determine the effect of topical aminocaproic acid on the incidence of rebleeding after traumatic hyphema. PATIENTS AND METHODS: This randomized double blind clinical trial investigated 132 consecutive cases of traumatic hyphema referred to the emergency room of Farabi Eye Hospital in 1998-1999. The patients were randomly divided into three groups: Group 1 received cycloplegic drops only. Group 2 received cycloplegic drops and 2% carboxy polymethylene (CPM) gel as placebo. Group 3 was treated with cycloplegic drops and 25% aminocaproic acid (ACA) in CPM gel (supplied by Messrs. Sina Darou). All patients were treated for five days on an outpatient basis, with a two-week follow-up. The incidence of rebleeding, time needed for clot absorption, and complications of hyphema were recorded and analyzed using the chi-square and Student's t-tests and logistic regression modeling. RESULTS: Rebleeding occurred in 8 eyes of 52 patients in group 1 (15.4%), 7 eyes of the 39 patients in group 2 (17.9%) and 5 eyes of the 41 patients in group 3 (12.2%). This difference was not significant. The time needed for clot absorption in groups 1, 2 and 3 was respectively 9.5 +/- 3.9, 9.3 +/- 4.2 and 11.15 +/- 4.7 days, the difference between group 3 and the other two groups being statistically significant (p<0.04). CONCLUSIONS: Topical 25% ACA is not effective in reducing the incidence of rebleeding and lengthens the time needed for clot absorption.

Administration, Topical↗
PubMedDate not supplied

Polaroid photorefractive screening of infants.

We modified a Polaroid SE camera for use as a photoretinoscope. A total of 187 infants between 2 and 18 months of age were photographed using this device. About half of these infants (97) participated in a double blind study in which the results of photorefraction were compared with those of standard cycloplegic retinoscopy. Eighty-three infants were photographed without cycloplegia. Thirty-four infants were photographed while cyclopleged. Photographs were evaluated for significant refractive errors and other ocular abnormalities. The effectiveness of the camera system to screen for significant refractive errors without the use of cycloplegia was assessed. Infants were identified to be at risk by photorefraction if, in any photograph, a hyperopic bright crescent calculated to be greater than or equal to +1.25 D was present in the pupil. Clinically significant refractive errors were defined by the results of cycloplegic retinoscopy: "at-risk" infants had either 3.5 D or more hyperopia in either eye, or astigmatism in either eye greater than or equal to 2.5 D, or anisometropia greater than or equal to 1.5 D. With these clinical criteria and the above photographic screening criterion, the camera's sensitivity and specificity were 83% and 69%, respectively. The present system compares favorably with earlier, more sophisticated units in alerting practitioners to potentially significant refractive errors in infants. Additionally, as a screening tool, this device offers the benefits of being inexpensive and easy to use, and of providing immediate feedback.

Calibration↗
PubMed2006

The effect of phenylephrine and cyclopentolate on objective wavefront measurements.

PURPOSE: To investigate the impact of phenylephrine and cyclopentolate on wavefront refraction and fourth order spherical aberration C12. METHODS: This cohort study comprised 151 eyes with sphere up to -10.00 diopters (D) and cylinder -3.75 D. Aberrometry was performed using the ALLEGRO WAVE (WaveLight Laser Technologies AG, Erlangen, Germany) after instillation of phenylephrine 5% yielding objective phenylephrine refraction in accommodated steady-state, as well as after cyclopentolate 0.5% providing objective cyclopentolate refraction in non-accommodated state. Accommodation target fogging was turned off. Wavefront aberrations were expressed by Zernike expansion up to the sixth order, and paraxial curvature matching with Taylor series was used to calculate objective wavefront sphere. RESULTS: Objective wavefront sphere was not influenced by pupil size. Eyes showed substantial accommodation after phenylephrine with a myopic shift of -0.66 D comparing objective to subjective manifest sphere (r=0.942, P<.001). Cycloplegic eyes behaved like a model eye, with a difference of -0.08 D between objective and subjective cycloplegic sphere (r=0.976, P<.001). C12 increased ten-fold from 4.0- to 7.0-mm pupil size, keeping the same sign. Comparing cyclopentolate with phenylephrine, the sign of C12 changed in a positive direction by an average +0.124 +/- 0.109 microm (range: -0.052 to +0.632 microm) at 7.0 mm, whereas the total higher order aberrations changed very little. A good correlation was found between C12 and the change in objective wavefront sphere between cyclopentolate and phenylephrine (r=0.75, P<.001). CONCLUSIONS: Fogging of the accommodation target should be used for wavefront measurements. Weaker cycloplegic agents, such as tropicamide, may be used to ensure relaxed but not completely paralyzed accommodation, which would yield "manifest" aberration values close to the natural resting state.

Accommodation, Ocular↗
PubMed1999

Ocular predictors of the onset of juvenile myopia.

PURPOSE: The purpose of this study was to identify reliable predictors of the onset of juvenile myopia. METHODS: The data from 554 children enrolled in the Orinda Longitudinal Study of Myopia (OLSM) as nonmyopes with baseline data from the third grade were evaluated to develop a predictive profile for later onset of juvenile myopia. Myopia was defined as at least -0.75 D of myopia in the vertical and horizontal meridians of the right eye as measured by cycloplegic autorefraction (n = 45 children). Chosen predictors were refractive error and the ocular components: corneal power, Gullstrand crystalline lens power, and axial length. Sensitivity and specificity were calculated. Receiver operating characteristic (ROC) curves were generated to evaluate and compare these predictors singly and combined. RESULTS: Refractive error, axial length, Gullstrand lens and pod corneal power were all significant predictive factors for the onset of juvenile myopia. The best single predictor of future myopia onset in the right eye was the right eye's cycloplegic autorefraction spherical refractive error value (mean sphere across 10 readings) at baseline. For a cut point of less than +0.75 D hyperopia in the third grade, sensitivity was 86.7% and specificity was 73.3%. The area under the ROC curve for this mean sphere was 0.880. Producing a logistic model combining mean sphere, corneal power, Gullstrand lens power, and axial length results in a slight improvement in predictive ability (area under the ROC curve = 0.893). CONCLUSIONS: Onset of juvenile myopia can be predicted with moderate accuracy using the mean cycloplegic, spherical refractive error in the third grade. Measurement of other ocular components at this age improves predictive ability, albeit incrementally. Further improvements in the prediction of myopia onset will require the use of longitudinal data in addition to one-time measurement of refractive error and the ocular components.

Adolescent↗
PubMed2001

Clinical evaluation of the Shin-Nippon SRW-5000 autorefractor in children.

The Canon Autoref R-1 is an 'open-field' autorefractor which has been widely used for research purposes for the past 20 years, but is no longer manufactured. A new autorefractor, the Shin-Nippon SRW-5000, is now available, and if measures using this instrument are shown to be equally accurate and reliable, is likely to replace the R-1. Here we report on the accuracy and reliability (repeatability and reproducibility) of refraction measures in a paediatric population (from 4 to 8 years of age). Subject numbers were 44 for cycloplegic measures and 53 for non-cycloplegic measures. As would be expected, agreement with cycloplegic refraction and reliability were better when SRW-5000 measures were taken using cycloplegia. Repeatability results from the SRW-5000 autorefractor, both with and without cycloplegia were similar to those reported for the Canon R-1.

Accommodation, Ocular↗
PubMed1998

[A research on clinical values of corneal topography and keratometer in measuring astigmatism].

OBJECTIVE: To compare the accuracy of corneal topography, keratometer and cycloplegic retinoscopy in measuring astigmatism for refractive surgery. METHODS: Three hundred and sixty eyes with ametropia were randomly selected. The results of corneal topography, that of keratometer and cycloplegic retinoscopy in measuring astigmatism before refractive surgery were compared, and the measuring results of corneal topography and that of keratometer for 72 eyes after photorefractive keratectomy (PRK) and 95 eyes after laser in situ keratomileusis (LASIK) were also compared. RESULTS: No significant difference was found in axes of astigmatism among the three groups. As for diopters of astigmatism, there was no significant difference between the group of corneal topography (DeltaSim K) and the group of keratometer (DeltaK), but we found significant difference between the group of cycloplegic retinoscopy and the other two groups before and after refractive surgery. Significant difference was also found between DeltaSimK and DeltaK after PRK and LASIK. CONCLUSIONS: Our investigation demonstrates that before refractive surgery the keratometer has a similar clinical value as that of corneal topography, and the DeltaSim K value is related to the graphic pattern of corneal topography. However, keratometer is limited in measuring mild changes in corneal curvature after refractive surgery, while the astigmatism expressed by DeltaSim K in corneal topography is more accurate.

Adolescent↗
PubMed1975

[Cycloplegia and residual accommodation (author's transl)].

The cycloplegic effect of 1% Atropine Sulphate, 2% Homatropine Hydrobromide and 1% Cyclopentholate (Cyclolat) were compared on 8 to 10 year-old children with hyperopic accommodation and partial accommodation squint. The objective refraction was measured by skiascopy and with Hartinger's refractometer, and these two values were compared. The distant-vision correction, and also the near-vision correction needed so that Table 2 of Pursch's Tables could be read, were measured. Atropine showed itself to be the most effective cycloplegic agent. With atropine cycloplegia was attained in 46.77% - shown by a necessary near-correction of +2 dioptres, or less. In 27.42% the correction was +1.5 dioptres. With homatropine a correction of +2 dioptres or less occurred in 82.14%, after Cyclogyl in 72.34%. Better cycloplegia could be reached, if before the test correcting spectacles are worn. Only with repeated refraction-tests to overcome accommodation spasm could one succeed in finding the complete hypermetropic state -- even with the help of a not very demanding cycloplegic agent like atropine. Cyclogyl was found to be the most suitable agent here.

Accommodation, Ocular↗
PubMed2005

Guidelines for prescribing optical correction in children.

As the eye grows, the axial length increases while the cornea and lens flatten. High refractive errors which are common in the neonatal period, reduce rapidly during the first year of life through the process called emmetropization. The possibility that long-term full- time glasses wear may impede emmetropization must be considered. Hyperopia greater than 5.00 diopters (D) in young children is associated with an increased risk of amblyopia and strabismus, therefore optical correction should be prescribed. When hyperopia is associated with esotropia, full correction of the cycloplegic refractive error should be prescribed. Myopia greater than 8.00 D and astigmatism greater than 2.50 D are common causes of isometropic amblyopia. Patients with hyperopic anisometropia with as little as l D difference between the eyes may develop amblyopia while the difference should reach 3-4 D for myopic anisometropia to develop amblyopia. Full cycloplegic refractive difference between two eyes should be given to the anisometropic child in spite of age, strabismus and degree of anisometropia. Myopia control is the attempt to slow the rate of progression of myopia such as cycloplegic agents, plus lenses at near, and rigid contact lenses.

Adolescent↗
PubMed1991

Possible allergic reactions to cyclopentolate hydrochloride: case reports with literature review of uses and adverse reactions.

Cyclopentolate has been widely used as a cycloplegic and mydriatic agent for over 30 years. It has gained widespread use as the cycloplegic drug of first choice for most children over the age of 1 year and allows many optometrists and ophthalmologists to carry out quick, successful cycloplegic refractions with few complications. During this time very few side-effects have been reported with the most commonly used 1% solution. This paper outlines two cases in which a possible allergic-type reaction occurred shortly after the instillation of 1% cyclopentolate hydrochloride in 'Minims' form (Smith and Nephew). This article also reviews the uses and side-effects of cyclopentolate and aims to warn practitioners about the possibility of such reactions, ways of avoiding their occurrence and suitable measures to take should they occur.

Child↗
PubMed1979

Paradoxical intraocular pressure response to pilocarpine. A proposed mechanism and treatment.

A patient with unilateral angle-recession glaucoma had an ipsilateral increased intraocular pressure (IOP) with miotics despite open angles, and decreased IOP with cycloplegics. The following mechanism is proposed to explain these findings: Pilocarpine hydrochloride has been demonstrated experimentally to increase trabecular outflow and decrease uveoscleral outflow. In this eye with a severely compromised and unresponsive trabecular outflow, miotics served to impair uveoscleral outflow and cause a net rise in IOP. Similarly, an increase in uveoscleral outflow with cycloplegics served to decrease IOP. The use of atrophine sulfate in these rate cases may be of therapeutic value in lieu of systemic or surgical therapy.

Atropine↗