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The oculocardiac reflex during ophthalmoscopy in premature infants
American Journal of Ophthalmology
|June 15, 1985
Insights
Pediatric ophthalmoscopy can trigger bradycardia (slow heart rate) in infants. Continuous monitoring revealed that 31% of infants experienced this cardiac event during eye exams.
Area of Science:
- Ophthalmology
- Pediatric Cardiology
Background:
- Ophthalmoscopy is a common procedure for examining infant eyes.
- Potential physiological responses during ophthalmoscopy require investigation.
Purpose of the Study:
- To assess the incidence of bradycardia in infants undergoing ophthalmoscopy.
- To identify specific stimuli during the procedure associated with bradycardia.
Main Methods:
- Continuous electrocardiographic monitoring was performed on 54 infants.
- Infants were referred for ophthalmoscopy with dilated pupils.
Main Results:
- 17 out of 54 infants (31%) exhibited bradycardia during the procedure.
- Bradycardia occurred coincident with eyedrop instillation, eyelid speculum insertion, globe pressure, or extraocular muscle stretching.
- Heart rate reductions ranged from 10% to 59% of baseline.
Conclusions:
- Infants are susceptible to bradycardia during ophthalmoscopy.
- Specific procedural elements can precipitate significant heart rate decreases in infants.
Abstract:
Of 54 consecutive infants referred for ophthalmoscopy with the pupils dilated, continuous electrocardiographic monitoring showed that 17 (31%) had bradycardia, ranging from 10% to 59% of baseline, coincident with instillation of eyedrops, insertion of an eyelid speculum, pressure on the globe, or stretching of the medial and lateral recti muscles.