Sector pupillary dilation: an alternative technique

Sector pupillary dilation is a method for controlled delivery of topical ophthalmic adrenergic agonists to stimulate the dilator muscle focally in patients predisposed to pharmacologically induced acute angle-closure glaucoma. Sector pupillary dilation can be achieved by applying a sterile cotton-tipped applicator moistened with 2.5% phenylephrine ophthalmic solution at the 6:00 o'clock limbus. A pilot study (N = 2) was conducted of one blue-eyed subject (M, age 38 years) and one brown-eyed subject (F, age 36 years) using drug contact times of 5 to 30 s in 5-s intervals. The horizontal and vertical pupil diameters were measured using photographs taken every 10 min for 1 h and every 20 min for the second hour. Sector pupil dilation developed with all application times. For the blue-eyed subject maximum sector dilation (delta = V-H = 1.5 mm) occurred with a 20-s contact time and peaked after 40 min. For the brown-eyed subject, the sector dilation effect was less marked and did not demonstrate a clear-cut peak time.