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Yakushigaku Zasshi 1994I discovered two prescriptions of mydriatic eye drops that seemed to be written by Von Siebold. One prescription (prescription 1) belongs to the Siebold Memorial Hall in...
I discovered two prescriptions of mydriatic eye drops that seemed to be written by Von Siebold. One prescription (prescription 1) belongs to the Siebold Memorial Hall in Nagasaki City, and the other (prescription 2) to the Municipal Museum in Ohzu City in Ehime Prefecture. Prescription 2 does not bear Siebold's signature but can be considered to have been written by him based on handwriting analysis. The major drugs in these prescriptions are Ex Belladonna and Ex Hyoscyamus. However, both prescriptions seem to have been written not only for mydriasis but also for antiphlogistic, analgesic and anticonvulsant effects in patients with eye disease. Based on the notes of the JP III and JP V, the mydriatics used by Siebold in operations such as for cataract were Ex Belladonna and Ex Hyoscyamus at a concentration of about 1%. Prescription 1. For a male with eye disease. Ex Belladonna 0.65 g; Laudanum 20 drops; Barium chloride 1.3 g; Rose water or chamomile water 124.4 g. Administer 3 times/day. Von Siebold (signature). Prescription 2. For Soya's daughter in Narutaki. Ex Hyoscyamus 0.39 g; Rose water 62.2 g. Administer some drops twice/day.
Topics: Eye Diseases; History, 19th Century; Humans; Japan; Mydriatics
PubMed: 11613514
DOI: No ID Found -
Journal of the American Optometric... Oct 1992Dilation of the pupil is a procedure with both clinical and legal ramifications. Optometrists must be familiar with the requirements of informed consent, which must be... (Review)
Review
Dilation of the pupil is a procedure with both clinical and legal ramifications. Optometrists must be familiar with the requirements of informed consent, which must be met when utilizing dilation on the 4-8 percent of patients with anterior chamber angles that are narrow enough to cause an angle closure. Optometrists also must recognize those circumstances under which pupillary dilation is necessary, both for symptomatic and asymptomatic patients. The correct drug regimen must be selected, whether it is for "routine" pupillary dilation or for a patient with a condition requiring a special drug regimen. Patients with dilated pupils must be appropriately managed, and failure to warn a patient of common and expected side effects may create liability if the failure to warn is the cause of injury. If complications--such as acute angle closure--occur, the optometrist must be prepared to manage the situation so as to minimize the risk of injury to the patient.
Topics: Eye Diseases; Fundus Oculi; Glaucoma, Angle-Closure; Humans; Informed Consent; Malpractice; Mydriatics; Optometry; Pupil
PubMed: 1430748
DOI: No ID Found -
Ophthalmology Nov 2022To calculate the cost savings associated with a multiuse preoperative and preinjection eyedrop protocol.
PURPOSE
To calculate the cost savings associated with a multiuse preoperative and preinjection eyedrop protocol.
DESIGN
Economic analysis.
PARTICIPANTS
Adults undergoing ophthalmic surgical procedures requiring preoperative dilation and intravitreal injections.
METHODS
Economic modeling with scenario analysis was used to derive the value for cost savings secondary to a protocol in which perioperative mydriatic eyedrop bottles are used across multiple patients versus the current protocol in which drop bottles are wasted after single-patient use. Similar analyses were performed for a multiuse povidone-iodine protocol for intravitreal injections. Sensitivity analyses were used to test baseline model assumptions with varying degrees of waste and patient volume.
RESULTS
The multiuse mydriatic protocol allowed for a 97.1% reduction in the number of eyedrop bottles required for the single-use protocol (1037 bottles vs. 35 850 bottles). This led to an estimated 5-year cost savings of approximately $240 000 (nominal) per institution (performing an average of 1434 cases/year) in the base case. This savings varied minimally in sensitivity analyses accounting for practical limitations (loss, expiration, or contamination) of multiuse containers, with savings of 97.54% to 95.00% for excess supply ranges from 0% to 100% in the multiuse protocol. Likewise, the cost savings varied minimally in sensitivity analyses for eyedrop sizes, with savings of 99.23% to 96.69% for mydriatic eyedrop sizes of 15 μl per drop to 65 μl per drop, respectively, in the multiuse protocol. Over a 5-year period, for povidone-iodine drops before performing intravitreal injection, the multiuse protocol required 153 bottles compared with 41 954 bottles (99.6% reduction) for the current single-use protocol, resulting in a nominal cost savings of $41 801, which varied minimally in sensitivity analyses.
CONCLUSIONS
Multiuse perioperative mydriatic eyedrops are a viable option for cost and environmental waste reduction for ophthalmologic procedures and surgeries requiring dilation. Likewise, multiuse povidone-iodine may allow for large relative cost reduction for in-office procedures. The total potential savings over 5 years was estimated at more than $280 000 before adjusting for inflation.
Topics: Adult; Humans; Ophthalmic Solutions; Cost Savings; Mydriatics; Povidone-Iodine; Intravitreal Injections
PubMed: 35772659
DOI: 10.1016/j.ophtha.2022.06.023 -
Postgraduate Medicine Feb 1996A red eye is a common complaint, often related to benign conditions. However, a red eye in conjunction with symptoms such as photophobia, pain, and decreased visual... (Review)
Review
A red eye is a common complaint, often related to benign conditions. However, a red eye in conjunction with symptoms such as photophobia, pain, and decreased visual acuity is an important clue to a much more serious disorder. Iritis is one of these but is reversible with proper use of mydriatic and cycloplegic agents and corticosteroids. Heightened clinical suspicion is necessary for timely diagnosis. The examiner should be skilled in the use of a slit lamp or should refer the patient to an ophthalmologist for immediate evaluation. Once the diagnosis is made, treatment with topical corticosteroids is imperative. Close monitoring is required because overuse of corticosteroids has ominous side effects.
Topics: Acute Disease; Administration, Topical; Adrenal Cortex Hormones; Adult; Female; Humans; Iritis; Mydriatics
PubMed: 8632971
DOI: No ID Found -
Deutsche Medizinische Wochenschrift... Feb 1974
Topics: Brain Concussion; Humans; Mydriatics
PubMed: 4818237
DOI: No ID Found -
Ophthalmic & Physiological Optics : the... Mar 1998Ophthalmic drugs, both diagnostic and therapeutic, play a central role in new developments in optometry, particularly as practitioners extend their involvement in... (Review)
Review
Ophthalmic drugs, both diagnostic and therapeutic, play a central role in new developments in optometry, particularly as practitioners extend their involvement in primary care. Optometrists now dilate more patients in routine practice, and this brings increasing concern about the risk of provoking acute closed angle glaucoma (CAG) attacks. It would seem that the risk of inducing acute CAG is far outweighed by the potential benefit of examining the eye through a dilated pupil. Driving difficulties, reported subjectively to be the result of glare, are frequently encountered by patients after dilation, and advice from the College of Optometrists is welcomed. The local anaesthetic proxymetacaine 0.5% is now marketed in the UK in preservative-free unit-dose applicators both alone and in combination with fluorescein, and is a more comfortable alternative to existing anaesthetics in unit-dose form. The second half of this paper includes a summary of the background to recent developments, as the UK profession takes its first steps towards the use of ocular therapeutic agents. Finally, some exciting new therapeutic preparations for use in the treatment of glaucoma, allergic eye disease, and dry eye conditions are discussed.
Topics: Anesthetics, Local; Conjunctivitis, Allergic; Dry Eye Syndromes; Glaucoma; Humans; Miotics; Mydriatics; Ophthalmic Solutions
PubMed: 9692028
DOI: No ID Found -
American Journal of Ophthalmology Jun 1957
Topics: Autonomic Agents; Glaucoma; Mydriatics
PubMed: 13424627
DOI: 10.1016/0002-9394(57)91806-8 -
Therapeutic Delivery Feb 2023To compare pupil dilation achieved by a single microdose versus two microdoses of tropicamide-phenylephrine fixed combination (TR-PH FC) delivered by the Optejet. In... (Randomized Controlled Trial)
Randomized Controlled Trial
To compare pupil dilation achieved by a single microdose versus two microdoses of tropicamide-phenylephrine fixed combination (TR-PH FC) delivered by the Optejet. In this assessor-masked, crossover, noninferiority study, 60 volunteers underwent two treatment visits and received either one (∼8 μl) or two sprays (∼16 μl) of TR-PH FC to both eyes in randomly assigned order. At 35 min postdose, mean change in pupil diameter was 4.6 mm and 4.9 mm following one or two sprays, respectively. The estimated treatment group difference was -0.249 mm (standard error: 0.036; 95% CI: -0.320, -0.177). No adverse events were reported. A single microdose was noninferior to two microdoses of TR-PH FC and achieved clinically significant mydriasis in a timely manner. Clinical Trial Registration: NCT04907474 (ClinicalTrials.gov).
Topics: Humans; Mydriatics; Pupil; Ophthalmic Solutions; Tropicamide; Phenylephrine
PubMed: 37158245
DOI: 10.4155/tde-2022-0061 -
Archives de Pediatrie : Organe Officiel... Apr 2017Mydriatic eye drops are indicated for ophthalmologic exams (fundus and cycloplegic effect for refraction diagnosis). Their use must be optimal to avoid adverse...
Mydriatic eye drops are indicated for ophthalmologic exams (fundus and cycloplegic effect for refraction diagnosis). Their use must be optimal to avoid adverse reactions. This is even more important in pediatrics, because few clinical studies were conducted in this population during drug development. We reviewed the use of mydriatic eye drops, gathering information from the Summary of Product Characteristics (SPC) from the Theriaque database (CNHIM) and the manufacturers' information, in terms of dose, concentration and volume administered, age limit indications, recommendations for administration, and our local practice. This tool is useful in our hospital for physicians, pharmacists, and nurses but could be also useful for all healthcare providers using mydriatic eye drops for children.
Topics: Age Factors; Child; Child, Preschool; Contraindications, Drug; Dose-Response Relationship, Drug; Eye Diseases; Fundus Oculi; Humans; Infant; Mydriatics; Ophthalmic Solutions; Refraction, Ocular
PubMed: 28259508
DOI: 10.1016/j.arcped.2016.12.012 -
The Journal of Pharmacology and... Apr 1976The experiments were designed to study the well-known pigment-dependent mydriatic effect of atropine in the eye. In vitro, relative to the accumulation of 3H-atropine by...
The experiments were designed to study the well-known pigment-dependent mydriatic effect of atropine in the eye. In vitro, relative to the accumulation of 3H-atropine by the nonpigmented rabbit iris, the pigmented iris accumulated high amounts of the drug. A nonpigmented tissue, stomch fundus strip, obtained from either albino or nonalbino animals, accumulated relatively low amounts of 3H-atropine. On repeated washings, the accumulated drug from the nonpigmented tissues was rapidly lost, T 1/2 of 14 minutes, while that accumulated by the pigmented iris was retained much longer. Although in vitro aqueous humor from serum-atropinesterase positive rabbits rapidly degraded atropine, extracts from irides of the same type of rabbit gave a single peak radioactivity, with Rf identical to the authentic atropine sulfate. The accumulation of 3H-atropine by pigmented human iris or pigment epithelium was similar to that observed for the pigmented rabbit iris. pA2 values of atropine from nonpigmented iris and from fundus strips varied between 8.58 and 8.88 with slope values close to 1. The pA2 value of atropine in pigmented iris was 8.82; at higher concentrations, atropine was less effective compared to the nonpigmented iris. In the pigmented iris, the lesser effectiveness of the drug at high concentration could be explained on the basis of accumulation of the drug by the pigment cell and its constituents. Thus, the free concentration of the drug in the vicinity of the muscarinic receptor will fall. The lesser concentration will give weaker muscarinic blockade in the pigmented iris. On repeated washing, the atropine blockade of the nonpigmented iris could be easily washed out while that in the pigmented iris was retained. In vivo, the relative T 1/2 for the duration of atropine mydriasis in rabbits were: albino atropinesterase-positive, 3.8 hours; nonalbino atropinesterase-positive, 12.4 hours; albino atropinesterase-negative is greater than or equal to 96 hours. Only the latter T 1/2 for the duration of atropine mydriasis is quite clear. The small magnitude of the mydriatic effect in humans is explained by the loss of free drug to the pigment cells and their constituents. The longer duration of mydriatic effect in the heavily pigmented eye is explained on the basis of slow release of the accumulated drug onto the muscarinic receptor.
Topics: Animals; Atropine; Epithelium; Esterases; Eye; Female; Humans; In Vitro Techniques; Iris; Male; Mydriatics; Pigmentation; Rabbits
PubMed: 1263134
DOI: No ID Found