Cycloplegic effect of atropine compared with cyclopentolate-tropicamide combination in children with hypermetropia

Sani, Rabi Yahaya; Hassan, Sadiq; Habib, Saudat Garba; Ifeanyichukwu, Ebisike Philips

doi:10.4103/0300-1652.184065

Cited by 17 publications

(9 citation statements)

References 12 publications

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“…The most probable hypothesis to justify the esophoric shift in cycloplegic conditions is related to localized accommodative paralysis and its relationship with near triad response. In fact, in cycloplegic conditions, ciliary muscles muscarinic receptors are locally inhibited, and the accommodation function is disrupted in the muscles involved in the accommodation, whereas using drops other than atropine does not tend to cause complete paralysis, [9,13] and the accommodative function partially remains. It is conceivable, however, that although the ciliary muscles are paralyzed, stimulus impulses of near triad response are still in action for accommodation, convergence, and miosis.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Cycloplegia on Ocular Alignment and AC/A Ratio

Asharlous,

Hashemi,

Yekta

et al. 2024

JOVR

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Purpose: The present study sets out to investigate the effect of cyclopentolate-induced cycloplegia on distance and near deviation and the accommodative convergence/accommodation (AC/A) ratio. Methods: This prospective study was performed on 30 subjects. The inclusion criteria included a lack of any active ocular pathology and systemic diseases, no history of ocular surgery, and nonuse of various medications. Refraction, near and distance deviation were measured for all subjects, and the same examinations were repeated after the administration of two drops of cyclopentolate 1% to both eyes. Results: The obtained data from 30 subjects, including 19 males, with a mean age of 22.53 ± 1.74 years were analyzed. The mean ± SD of near deviation in dry and cycloplegic conditions were – 6.9 ± 8.1 and +6.4 ± 9.1 prism diopters, respectively, which were statistically significant (P < 0.001). Distance deviation in cycloplegic conditions demonstrated an average difference of 0.8 prism diopters, compared to dry conditions (P < 0.001). AC/A ratios were 4.7 ± 2.5 and 9.7 ± 3.9 (Δ/D) in non-cycloplegic and cycloplegic conditions, respectively, which was a statistically significant difference (P < 0.001). The multiple regression indicated that among all under study variables, refraction (B coefficient: –2.4; P < 0.001) and near pre-cycloplegic deviation (B coefficient: 0.56; P < 0.001) were significantly associated with post-cycloplegic near deviation. Conclusion: The results of this study indicated that cycloplegia causes a considerable esophoric shift in near deviation and a negligible esophoric shift in distance deviation. As a result, the AC/A ratio demonstrated a significant increase due to unequal changes in near and distance deviation.

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Section: Discussionmentioning

confidence: 99%

The Effect of Cycloplegia on Ocular Alignment and AC/A Ratio

Asharlous,

Hashemi,

Yekta

et al. 2024

JOVR

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“…27 Cycloplegic refraction is generated by applying 1% atropine eye drops twice per day for three days prior to the refraction, or 1% cyclopentolate and 1% tropicamide eye drops twice with a five-minute interval. 34 The difference in refraction between manifest and cycloplegic refraction is dependent on the normal refractive state and is a natural component of latent refractive error. The differences between emmetropia and hypermetropia patients are more evident.…”

Section: Assessment and Diagnosismentioning

confidence: 99%

Accommodative spasm and its different treatment approaches: A systematic review

Manna

Karmakar

Bhardwaj

et al. 2022

European Journal of Ophthalmology

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This article is about the accommodation spasm. The primary rule for near vision is ciliary muscle constriction, synchronised convergence of both eyes, and pupil constriction. Any weaknesses in these components could result in an accommodative spasm. Variable retinoscopic reflex, unstable refractive error, and lead of accommodation in near retinoscopy are common causes of spasm. We conducted a thorough literature search in the PubMed and Google Scholar databases for published journals prior to June 2022, with no data limitations. This review contains twenty-eight case reports, six cohort studies, four book references, four review articles, and two comparative studies after applying the inclusion and exclusion criteria. The majority of studies looked at accommodative spasm, near reflex spasm, and pseudomyopia. The most common causes of accommodative spasm are excessive close work, emotional distress, head injury, and strabismus. Despite side effects or an insufficient regimen, cycloplegic drops are effective in diagnosing accommodation spasm. The modified optical fogging technique is also effective and may be an option for treating accommodative spasm symptoms. Bifocals for near work, manifest refraction, base-in prisms, and vision therapy are some of the other management options. As a result, it requires a comprehensive clinical treatment strategy. This review aims to investigate the various aetiology and treatments responsible for accommodative spasm and proposes widely implementing the modified optical fogging method and vision therapy in clinics as comprehensive management to reduce the future upward trend of accommodative spasm.

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“…Systemic ataxia disorientation, speech impairment, and hallucinations may also occur. 7 Tropicamide is a synthetic analog of tropic acid. Its effects start at 20–30 min and continue for up to 6 h. 8 Systemic side effects such as sensations of the eye sinking, corneal irritation, tachycardia, dry mucous membranes, and flushing can be seen.…”

Section: Introductionmentioning

confidence: 99%

“…Its effects start at 20–30 min and continue for up to 6 h. 8 Systemic side effects such as sensations of the eye sinking, corneal irritation, tachycardia, dry mucous membranes, and flushing can be seen. 7 Tropicamide is preferred more often because its effects start earlier and it has fewer side effects than other agents.…”

Section: Introductionmentioning

confidence: 99%

Effect of cycloplegic agents (1% cyclopentolate hydrochloride and 1% tropicamide) on anterior segment parameters

Duran¹,

Cevher

2023

Ophthalmol Eye Dis

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Background: Cycloplegic drops are commonly used in ophthalmology practice. Changes in anterior segment parameters may occur after cycloplegia. These changes can be evaluated with corneal topography. Objective: This study aimed to compare the effects of 1% cyclopentolate hydrochloride and 1% tropicamide on anterior segment parameters using the Sirius Scheimpflug imaging technique. Design: A cross-sectional study. Methods: One hundred twenty eyes of sixty healthy volunteers with spherical equivalent (SE) values of 0 to ±1 diopter (D) were studied. The right eye of each subject had instillation of cyclopentolate hydrochloride 1% (Group 1) and the left eye of each subject had instillation of tropicamide 1% (Group 2). SE, intraocular pressure, and corneal topography measurements were performed before and 40 min after instillation were compared. Results: In Group 1, SE, aqueous depth, anterior chamber depth, iridocorneal angle (ICA), anterior chamber volume (ACV), and pupil size (PS) values were significantly increased ( p < 0.001, p = 0.01, p < 0.001, p = 0.03, p < 0.001, and p < 0.001, respectively). In Group 2, SE, ICA, ACV, and PS were significantly increased ( p < 0.001 for all). Keratometric values (K1 and K2) and central corneal thickness changed insignificantly in both groups ( p > 0.05). The effects of the two administered agents on all parameters were similar ( p > 0.05). Conclusions: Cyclopentolate hydrochloride and tropicamide affected SE, ICA, ACV, and PS values significantly. These parameters are important in intraocular lens (IOL) power calculations. PS is also important in refractive surgery and cataract surgery with multifocal IOL implantation. Although there was an insignificant difference between the agents, the effects of tropicamide on the parameters were smaller than those of cyclopentolate.

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Cycloplegic effect of atropine compared with cyclopentolate-tropicamide combination in children with hypermetropia

Cited by 17 publications

References 12 publications

The Effect of Cycloplegia on Ocular Alignment and AC/A Ratio

The Effect of Cycloplegia on Ocular Alignment and AC/A Ratio

Accommodative spasm and its different treatment approaches: A systematic review

Effect of cycloplegic agents (1% cyclopentolate hydrochloride and 1% tropicamide) on anterior segment parameters

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