Mydriatics, Cycloplegics, Dilation of the Pupil

Question 1

Mydriatics

Answer 1

induces dilation

Question 2

Using local anesthetics before mydriatics

Answer 2

decreases blinking and tearing

changes permeability of epithelium causing faster dilation

Question 3

Side Effects of Dilation

Answer 3

blurred vision, esp at near
photophobia
angle closure

Question 4

Why do light eyes dilate faster

Answer 4

less pigment in iris to sequester drug

Question 5

Populations with a smaller pupil

Answer 5

older
poorly controlled diabetes
both dilate slower

Question 6

Sympathetic Pathway

Answer 6

Hypothalamus - Ciliospinal center of Budge - Superior Cervical Ganglion - Dilator

Question 7

Parasympathetic Pathway

Answer 7

Pretectal Nucleus - E-W Nucleus - Ciliary Ganglion - Sphincter

Question 8

Cholinergic Antagonists

Answer 8

inhibits pupillary sphincter- dilation

inhibits ciliary body- cycloplegia

Question 9

Uses of Cholinergic Antagonists

Answer 9

cycloplegic refraction
pupillary dilation
management of uveitis

Question 10

Examples of Cholinergic Antagonists

Answer 10

Scopolamine
Tropicamide
Atropine
Cyclopentolate
Homatropine

Question 11

Scopolamine

Answer 11

often used for motion sickness
used when allergic to all others
most likely to have CNS toxicity

Question 12

Tropicamide

Answer 12

drug of choice for routine mydriasis
fastest onset and shortest duration
no systemic side effects

Question 13

Difference between 0.5% and 1.0% Tropicamide

Answer 13

same mydriatic effect

1% has greater cycloplegic effect

Question 14

Atropine

Answer 14

longest effects
for refractions for accomodative esotropia
substitute for patching for amblyopia

Question 15

Systemic SE of Atropine

Answer 15

6 deaths

never use with Down’s Syndrome

Question 16

Cyclopentolate

Answer 16

drug of choice for routine cycloplegic refraction

Question 17

Homatropine

Answer 17

standard for treating anterior uveitis

Question 18

Phenylephrine

Answer 18

stim alpha adrenergic receptors, producing dilation via radial mm
dilation without cycloplegia
differentiates scleritis and episcleritis- blanched conjunctival vessels means episcleritis

Question 19

Cannot use Phenylephrine

Answer 19

MAOI
tricyclic antidepressants
Grave’s Disease

Question 20

Paremyd

Answer 20

Hydroxyamphetamine- causes release of NE
Tropicamide
Dilation without cycloplegia
used after cocaine to determine lesion location in Horner's
does not elevate IOPs