Document Detail

Cycloplegia in African-American children.
MedLine Citation:
PMID:  10082056     Owner:  NLM     Status:  MEDLINE    
PURPOSE: The selection of a cycloplegic agent depends on the desired outcome, the characteristics of the patient receiving the drug, and the associated risks. The Orinda Longitudinal Study of Myopia (OLSM) has used 1% tropicamide to assess the ocular components and cycloplegic refractions in a large cohort of predominantly Caucasian children. Although tropicamide has provided adequate cycloplegia and mydriasis for the OLSM cohort, conventional clinical wisdom and scientific investigations have suggested that tropicamide might not produce adequate cycloplegia and mydriasis for subjects with darker iris pigmentation. In this study one drop of 1% tropicamide followed by one drop of 1% cyclopentolate was used to determine their effectiveness in producing adequate cycloplegia and mydriasis for cycloplegic refraction and ocular component measurements in a group of African-American children. METHODS: Nineteen children [age range 5.5 to 15.6 years, mean 8.4 years +/- (SD) 2.5 years] were tested at Family HealthCare of Alabama, Eutaw, AL. Their accommodative responses were measured using a Canon R-1 autorefractor prior to and at 30, 45, and 60 min after instillation of one drop of 0.5% proparacaine, 1% tropicamide (Mydriacyl), and 1% cyclopentolate (Cyclogyl) in both eyes. A target of 20/155 letters in a 4x4 grid positioned behind a +6.50 diopter (D) Badal lens provided accommodative stimuli of 1.00 D, 2.00 D, and 4.00 D. RESULTS: All results are presented as mean +/-1 SD. Pupils, measured from video frames, dilated rapidly and maximally at 30 min after instillation of eye drops (7.3+/-0.5 mm) Predilation, the mean accommodative responses were 0.17+/-0.29 D for the 1.00 D stimulus, 1.01+/-0.40 D for the 2.00 D stimulus, and 2.77+/-0.74 for the 4.00 D stimulus. At 30 min after drop instillation, the responses were 0.07+/-0.14 D for the 1.00 D stimulus, 0.36+/-0.35 D for the 2.00 D stimulus, and 0.77+/-0.61 for the 4.00 D stimulus. Results were very similar at 45 and 60 min after drop instillation. CONCLUSIONS: Combining 1% tropicamide and 1% cyclopentolate was very effective in providing both cycloplegia and mydriasis adequate for ocular biometry and cycloplegic refractions 30 min after drop instillation in African-American children.
R N Kleinstein; D O Mutti; R E Manny; J A Shin; K Zadnik
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Optometry and vision science : official publication of the American Academy of Optometry     Volume:  76     ISSN:  1040-5488     ISO Abbreviation:  Optom Vis Sci     Publication Date:  1999 Feb 
Date Detail:
Created Date:  1999-05-04     Completed Date:  1999-05-04     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8904931     Medline TA:  Optom Vis Sci     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  102-7     Citation Subset:  IM    
University of Alabama at Birmingham School of Optometry, USA.
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MeSH Terms
Accommodation, Ocular / drug effects*
African Americans*
Ciliary Body / drug effects*
Cyclopentolate / administration & dosage,  therapeutic use
Drug Therapy, Combination
Eye Color
Follow-Up Studies
Iris / physiology
Mydriatics / administration & dosage,  therapeutic use*
Ophthalmic Solutions / administration & dosage,  therapeutic use
Propoxycaine / administration & dosage,  therapeutic use
Pupil / drug effects
Refraction, Ocular / drug effects*
Tropicamide / administration & dosage,  therapeutic use
Grant Support
Reg. No./Substance:
0/Mydriatics; 0/Ophthalmic Solutions; 1508-75-4/Tropicamide; 499-67-2/proxymetacaine; 512-15-2/Cyclopentolate; 86-43-1/Propoxycaine

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