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Counteracting the effects of mydriatics. Does it benefit the patient?

The effect of 2% pilocarpine nitrate in countering mydriasis, cycloplegia, and change in visual acuity due to 0.5% tropicamide was studied in 23 healthy volunteers. There was no significant difference in the decrease in pupil size or the rate of return of accommodation between the eye that received pilocarpine and the control eye. The effect of tropicamide on visual acuity was slight. In four (17%) of 23 eyes that received pilocarpine, visual acuity was reduced to 6/36 or worse. It is suggested that the use of 2% pilocarpine in the attempted reversal of 0.5% tropicamide to improve a patient's vision is not helpful and may possibly be harmful.

Accommodation, Ocular↗

Acute gastric dilatation complicating the use of mydriatics in a preterm newborn.

A 2-month-old girl who had been born at 27-weeks' gestation was admitted for her screening examination for retinopathy of prematurity and given two drops each of cyclopentolate 0.5% and phenylephrine 2.5%. Approximately 2 h after completion of the examination, the infant had episodes of apnoea and vomiting. She was noted to be distended, and an abdominal radiograph demonstrated acute gastric dilatation. Apnoea, vomiting and distension resolved after 18 h and a repeat abdominal radiograph demonstrated resolution of the gastric dilatation.

Acute Disease↗