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PubMed1994

Ocular effects and systemic absorption of cyclopentolate eyedrops after canthal and conventional application.

Ocular effects and plasma concentrations of cyclopentolate were studied in 8 volunteers after eyedrop application with two methods. While recumbent two 30 microliters drops of 1% cyclopentolate hydrochloride were instilled in randomized order either conventionally to the lower conjunctival cul-de-sac or on the inner canthus with eyes closed, followed by immediate opening of the eyes. The cycloplegic responses as well as the extent and time of maximal mydriasis did not differ significantly between the two methods. None of the parameters describing the systemic absorption of the drug differed between the treatment groups. Conventionally applied drops caused slightly longer subjective discomfort. Instilling eyedrops on the inner canthus with eyes closed is an alternative method to deliver ocular cyclopentolate with similar efficacy and safety as the conventional technique. This method could be useful especially when treating non-cooperative children.

Absorption↗
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

[Cycloplegia with cyclopentolate for testing-refraction of children (author's transl)].

A comparative study of the cycloplegic effect of 1% cyclopentolate and atropine or homatropine was done by means of Lindner's method of retinoscopy. In 53% of 1.5- to 6-year-old strabismic patients the hypermetropic refraction was higher (average 0.6 dpt) under the use of atropine, and in 27% of 6- to 11-year-old children cyclopentolate was more effective than homatropine (average 0.5 dpt). Therefore, atropine should be used for children with convergent squint up to 6 years, in order to get full correction of hypermetropia. In other cases cyclopentolate is preferable because of its rapid and strong efficiency of brief duration.

Accommodation, Ocular↗
PubMed1973

Cyclopentolate in treatment of sarin miosis.

1. Six young male volunteers were exposed to sarin vapour (isopropyl methyl phosphonofluoridate) at a concentration of 0.5 mg/m(3) for 30 min (concentration time (Ct) 15 (mg min)/m(3)).2. The resulting clinical syndrome was treated by instilling 0.06 ml of a 1% solution of cyclopentolate into the conjunctival sac.3. Visual acuity, retinoscopy, objective and subjective refraction and pupil sizes were noted before the trial, after exposure to sarin and after treatment with cyclopentolate.4. No appreciable difference was demonstrated between the control objective retinoscopy values and those obtained after cyclopentolate treatment of the clinical syndrome induced by sarin. Reduced near visual acuity was observed in some subjects treated with cyclopentolate as compared with acuity after exposure to sarin alone, considered to be due to the partial cycloplegia produced by treatment. Visual acuity after exposure to sarin alone was improved in some instances by the miosis produced.5. It is suggested that unless full dark adaptation is a consideration, treatment of the ophthalmic condition resulting from exposure to this dosage of sarin should be reserved for those experiencing distressing ocular symptoms.

Adult↗
PubMed1992

[The cycloplegic effect of atropine in comparison with the cyclopentolate-tropicamide-phenylephrine combination].

Atropine is thought to produce the most effective cycloplegia in early childhood. Cyclopentolate and Tropicamide are the best known short acting cycloplegic agents. Phenylephrine is an adrenergic agent and has also a cycloplegic effect. In this study we compared a combination of Cyclopentolate, Tropicamide and Phenylephrine with Atropine and observed no difference between them.

Accommodation, Ocular↗
PubMed1990

Seizures associated with 1% cyclopentolate eyedrops.

A 4.5 year old boy with cerebral palsy presented with seizures associated with facial flushing and tachycardia following the instillation of 1% cyclopentolate, a commonly used mydriatic in paediatric practice. He had no prior history of convulsions. This case demonstrates the uncommon, though serious, atropine-like side effect of cyclopentolate eyedrops (Cyclogyl, Alcon) in usual dosage in a brain damaged child without an epileptic focus.

Cerebral Palsy↗
PubMed1976

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. I. Effect on intraocular pressure.

The mydriasis provocative test with 1% cyclopentolate (CPT) was performed on 218 patients with suspected or untreated open-angle glaucoma, on 431 eyes in all. Gonioscopy was performed before and during the test to ensure that te chamber angles were open throughout. The effect of cyclopentolate on intraocular pressure (10P) in these eyes is reported in the present paper. The mean change in IOP (+/-SD) During CPT was +2.5 +/- 3.1 mmHg in the glaucoma group (196 eyes), +0.4 +/- 2.5 mmHg in the group with suspicion of open-angle glaucoma (235 eyes), and +1.4 +/- 2.9 mmHg in the total series. The difference in IOP change between the groups with glaucoma and suspected glaucoma is statistically highly significant. The incidence of positive responses (IOP rise larger than or equal to 8 mmHg) in the glaucoma group (8.7%: 17 eyes) was significantly higher than in the suspicion group (1.7%: 4 eyes). Significant IOP elevations in the total series were demonstrated in 21 eyes of 18 patients (4.9%). Including the borderline cases, IOP elevations larger than or equal to 5 mmHg were also significantly more frequent in eyes with glaucoma (24.0%: 47 eyes) than in eyes with suspected glaucoma (11.9%: 28 eyes). The occurrence and magnitude of positive responses were not dependent on the initial IOP level. Further analysis of the responder group and clinical studies of the mechanism of IOP elevation on the same patients are presented in parts II and III.

Adult↗
PubMed1985

A cross-over study of the cycloplegic effects of a single topical application of cyclopentolate-phenylephrine and routine atropinization for 3.5 days.

Static refraction in children after the topical instillation of atropine twice a day during 3.5 days was compared with the refraction after a single instillation of one drop of 0.85% cyclopentolate + 1.5% phenylephrine in a randomized cross-over study. Atropine eye drops were applied by the parents at home, while the combination drop was applied by personnel at the eye clinic. Refraction was determined by retinoscopy in 40 children (3-6 years) in a single blind manner. No statistically significant difference in cycloplegic effect was found between the 2 methods. The results imply that in clinical practice a single instillation of a combination of 0.85% cyclopentolate and 1.5% phenylephrine can be substituted for conventional "full" atropinization during 3.5 days.

Accommodation, Ocular↗
PubMed1979

Refraction of 1-year-old children after cycloplegia with 1% cyclopentolate: comparison with findings after atropinisation.

Cyclopentolate 1% is significantly less effective than atropine 1% at producing cycloplegia in 1-year-old children. If cycloplegic refraction is to be used for investigation or screening children for visual defects during the sensitive period, the more prolonged and profound cycloplegia following atropine could potentially have a disastrous effect on the development of vision. Cyclopentolate 1% would have to be used, and allowance made for its inadequacy as a cycloplegic.

Atropine↗
PubMed1986

Effects of 0.1% cyclopentolate or 10% phenylephrine on pupil diameter and accommodation.

The mydriatic and cycloplegic effects of either one drop of 0.1% cyclopentolate or two drops of 10% phenylephrine were studied over a period of up to 6 hours after drug instillation, using 5 subjects aged between 25 and 43 years. The extent of mydriasis was determined from the horizontal diameter of the pupil. Dynamic accommodation responses were monitored with an infra-red, continuously recording optometer. Static measurements of the accommodation response/stimulus curve were made with a laser optometer. With either drug, dilation of the pupil occurred more rapidly than recovery of normal pupil diameter. Both drugs caused alterations in the dynamic and static accommodation responses. Response times were generally slowed, and the slope of the accommodation response/stimulus curve and the amplitude of accommodation were reduced. The time course of these changes was broadly similar to that of the pupil dilation. Cyclopentolate hydrochloride was more efficient as a mydriatic but exercised a greater unwanted cycloplegic effect.

Accommodation, Ocular↗
PubMed1976

Adverse systemic reactions of topical cyclopentolate hydrochloride.

Systemic toxic effects of 2% cyclopentolate eye drops were studied in 66 adults. Out of these, 10 developed systemic toxic reactions. In 6 cases it was mild and in the remaining 4 cases the severity was moderate. Recovery was complete without any treatment. It is suggested that the use of 2% cyclopentolate drops should be restricted, and weaker concentrations applied with caution.

Administration, Topical↗
PubMed1976

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. II. Clinical studies on the mechanism of intraocular pressure elevations.

The mydriasis provocative test with 1% cyclopentolate (CPT) was performed on 218 patients with suspected or untreated open-angle glaucoma, on 431 eyes in all. Significant IOP elevations (larger than or equal to 8 mmHg) were demonstrated in 21 eyes of 18 patients. The present paper analyses the responder group and presents some other investigation results and clinical findings to throw additional light on the mechanism of IOP elevation in responders. The responders did not differ from the other patients of the material in age or sex. Patients with capsular glaucoma constituted the biggest group among the responders. 48% of the significant IOP elevations during CPT were encountered in eyes with pseudoexfoliation (PE) and open-angle glaucoma. A positive response during CPT was statistically significantly more common in PE eyes than in eyes without PE. Capsular glaucoma was diagnosed immediately or later in all PE eyes which displayed a larger than or equal to 5 mmHg IOP elevation during the CPT. In addition to the importance of pigment in PE eyes, PE material may play a certain role in the elevation of IOP . The mechanism of this role is not known. No correlation was established between the results of the water drinking test and the CPT. The mechanism that causes the elevation of IOP must be quite different in these two tests. Nor was a statistically significant difference observed in the incidence of cataract, the maximal variation of IOP in the 48-h tension curve, the occurrence of cupping of the optic disc or visual field defects between the responder and non-responder eyes in the glaucomatous group.

Adult↗
PubMed1976

The cyclopentolate provocative test in suspected or untreated open-angle glaucoma. V. Statistical analysis of 431 eyes.

The mydriasis provocative test with 1% cyclopentolate (CPT) was performed on 431 eyes with suspected or untreated open-angle glaucoma. Tonography was performed both before and during CPT to study the changes in aqueous dynamics during the test. Statistical analysis of the results yielded the following mean trends and correlations at a highly significant level (P less than 0.001) in the alterations: Intraocular pressure (IOP) rose (deltaP +/- SD) (+ 1.4 +/- 2.9 mmHg) and aqueous outflow facility decreased (deltaC) (-10%) during CPT. The distribution of deltaP and deltaC did not follow the normal Gaussian distribution. The change in deltaP deviated from the Gaussian distribution in 5-10% of the eyes. The deviating values concur with those of the responder eyes in which IOP rose greater than or equal to 8 mmHg during CPT. deltaP was linearly dependent on the initial IOP level Po and the absolute change was always almost constant, approximately +1.4 mmHg. Both the total series and the responder eyes displayed the same trend for the change in aqueous outflow facility in relation to the initial C value (Co): low Co values changed less on average and high Co values changed more and diminished. It is not known why the deltaC change was different depending on the Co value. The change in IOP correlated statistically highly significantly in the initial C value (Co). The loqwe the Co value, the higher was the mean IOP elevation during CPT. In contrast, the change in aqueous outflow (deltaC) did not corrrelate (N.S.) with the initial IOP level (Po) before CPT.

Aqueous Humor↗
PubMed1976

[Diagnostic and therapeutic use of cyclopentolate cycloplegia].

0,5 p. 100 Cyclopentolate is an important short-acting cycloplegic and mydriatic preparation. It has the same effect on accommodation as the prolonged instillation of Atropine. Nevertheless it must be remembered that it is not a perfect cycloplegic; just as much as with Atropine resistance is frequently found in young children, in subjects with brown irides, in pigmented races, and above all in cases where there is a tonic spasm of accommodation producing functional signs or oculomotor imbalance.

Age Factors↗
PubMed1979

[Acute psychosis after cyclopentolate-HCL (Zyklolat) (author's transl)].

Symptoms of poisoning were noticed in a eight-year-old boy after prescribed application of cyclopentolate 1 per cent (as declared by manufacturing firm). Acute psychosis disappeared spontaneous 3,5 hours later. Pharmacological analysis of the eye-drops showed that concentration of active agent wasn't 1 per cent but 1.31 per cent.

Child↗
PubMed1981

Effect of combined 1% cyclopentolate-10% phenylephrine eye drops on systemic blood pressure of glaucoma patients.

Sixty-two patients with glaucoma had eye drops containing 1% cyclopentolate hydrochloride and 10% phenylephrine hydrochloride applied two or three times to one or usually both eyes to dilate their pupils as part of routine eye examinations. Systemic (brachial) blood pressure was monitored before and after drug application. Fifty of the patients had either no change in blood pressure or a decrease. Only two patients had a rise of 20 mm Hg or more in either systolic or diastolic blood pressure. In these two cases the increases were 34/4 and 22/20 mm Hg. Ten patients had an increase ranging from 10 to 20 mm Hg in either systolic or diastolic pressure. The results suggest that a clinically dangerous rise in systemic blood pressure from use of these drops is not common. However, to lessen the risk further, it seems advisable to use drops containing 10% phenylephrine only when lower concentrations are ineffective in dilating the pupils.

Aged↗
PubMed1976

Systemic toxicity of cyclopentolate hydrochloride in adults following topical ocular instillation.

A case reported of a 27-year-old white woman who developed systemic toxicity after the local instillation of one drop of 2% cyclopentolate solution in each eye. The usefulness and toxic reactions of this very valuable drug are discussed. It is recommended that every ophthalmologist should warn not only the parents of the children, but also the adult patients about the possibility of systemic reaction before this drug is used and where possible the lowest concentration of solution be used. It is also suggested that a sufficient amount of injectable physostigmine salicylate be kept handy in the office emergency kit.

Adult↗