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Updated: Jun 24, 2026

Diagonal Method to Measure Synergy Among Any Number of Drugs
Published on: June 21, 2018
The comparison of mydriatic effect between two drugs of different mechanism
Ji-Hyun Park1, Young-Chun Lee, Se-Youp Lee
1Department of Ophthalmology, College of Medicine, Keimyung University of Korea, Daegu, Korea.
Purpose:
To maximize effective use of mydriatic drugs through comparing the pupillary dilation effects between 1% tropicamide and 2.5% phenylephrine.
Methods:
Fifty people requiring pupillary dilation were divided into 3 groups. Group 1 was treated with one drop of 1% tropicamide in the right eye and one drop of 2.5% phenylephrine in the left eye. Group 2 was treated twice during a 5-minute interval with 1% tropicamide in the right eye. Group 3 was treated twice during a 5-minute interval with 2.5% phenylephrine in the right eye. Groups 2 and 3 were treated with 2.5% phenylephrine and 1% tropicamide in the left eye, administered during a 5-minute interval. The pupillary size was measured in all groups for 40 minutes following eye drops administration.
Results:
The mean patient age was 15.7 years. Group 1 included 10 patients, and groups 2 and 3 included 20 patients each. Eight patients in group 1 and 16 patients in group 2 developed a larger right pupil. Fourteen patients in group 3 developed a larger left pupil.
Conclusions:
Our study showed that 1% tropicamide, with its parasympathetic antagonistic mechanism of action, was more effective at inducing pupillary dilation than 2.5% phenylephrine, and the combination of 1% tropicamide and 2.5% phenylephrine was more effective than multiple drops of single eye drops.
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