Cycolplegic

Question 1

what is cycloplegia

Answer 1

loss of accommodative function, hence cycolpegic dilation drops

Question 2

what is mydriasis

Answer 2

pupillary dilation

Question 3

what are cycloplegic drugs

Answer 3

agents which block the PNS in the iris and ciliary body, results in loss of accommodation and pupillary dilation

Question 4

What are the 3 most common cycloplegic in the optometric field ?

Answer 4

atropine
cyclopentolate (0.5% and 1.0%)
tropicamide (0.5% and 15)

Question 5

what is the association of scopolamine agent

Answer 5

found in motion sickness medication
side effect: no accommodation

Question 6

what is amplitude of accommodation

Answer 6

the maximum amount a pt can accommodate

Question 7

what are the indications to perform cycloplegic refraction

Answer 7

• pt cannot fixate steadily or reduce accommodation (young child)
• ocular deviation, esotropia
• a lot more plus power ( or less minus) found in ret than subjective
• amplitude of accomm doesnt fall within normal limits of pt age group

Question 8

what is pseudomyopia

Answer 8

the increased distance blur during evening

Question 9

what is latent hyperopia

Answer 9

hyperope who may have masked accommodation, thus the agent will find the excess accommodation

Question 10

define far point

Answer 10

point conjugate with the retina of the unaccommodated eye

Question 11

what are the symptoms of apparent refractive origin

Answer 11

transient blur
occasional horizontal diplopia
headaches after near work

Question 12

what are the advantages to cycloplegic refraction

Answer 12

• makes latent RE manifest
• allows refractive assessment w/o accommodative fluctuations
• avoids off axis ret erros
• allows dilated fundus examination

Question 13

what is the significance of cycloplegic for ret

Answer 13

parallel with their visual axis to get a more precise finding

Question 14

what are disadvantages of cycloplegic refraction

Answer 14

• atropine > possible systemic poisoning in young children
• mydriasis > induce angle closure > increased IOP
• increased abberations from the pupil on ret, essential to only consider central reflex
• changes of crystalline lens shape vs normal conditions, but will come back to normal state once agent wears off
• photophobia (light sensitivity), decreasing VA and near work abilities
• potential for adverse rxn (allergic rxn)

Question 15

adequate cycloplegia

Answer 15

an amplitude of accommodation less than 2D (pt closest distance of vision = 50cm)

Question 16

what is atroprine cyclo agent used for

Answer 16

myopia control

Question 17

what are the cyclo drugs > onset and > duration

Answer 17

tropicamide (0.5 and 1%) > 20-30 mins > 4-8 hrs
cyclopentolate > 20-45 mins > 8-24 hrs
homatropine > 30-60 mins > 24-48hrs
scopolamine > 30-60 mins > up to 7 days
atropine > 3-6 hrs > 10-18 days

tiny children have small ankles

Question 18

pre dilation precautions in pts includes

Answer 18

• history: dilated eye exam prior and of any abnormal findings, or glc
• tonometry: measure IOP before and after seeing pt to gauge circadian flow
• assessment of angle via gonioscopy/ slit lamp

Question 19

how should the drug installation be done

Answer 19

teens and adults - two drops 5 mins apart as our socket can only hold so much

Question 20

what us the fatal dosage of atropine in infants and children

Answer 20

infants: as low as 10mg
children: between 10-20mg

Question 21

in the event a patient has esotropia and cycloplegic refraction wasnt performed, what would happen

Answer 21

uncorrected eso-myopia leads to amblyopia > reduced BVA

Question 22

3g tube of 1% atropine eye ointment contains 30mg of atropine which is

Answer 22

3x the fatal systemic dosage