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Efficacy of a pediatric cycloplegic administered as a spray
J D Bartlett1, M D Wesson, J Swiatocha
1School of Optometry, University of Alabama at Birmingham 35294.
Insights
Administering cycloplegic medication via spray to a child's closed eye is as effective as traditional eyedrops. This spray method offers potential clinical benefits for pediatric eye exams.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Topical eyedrop administration is challenging in pediatric patients.
- Investigating alternative drug delivery methods for cycloplegic solutions is needed.
Purpose of the Study:
- To evaluate the efficacy of a combination mydriatic-cycloplegic solution delivered as a spray compared to eyedrops.
- To determine if spray administration to open or closed eyes impacts cycloplegic effectiveness.
Main Methods:
- Prospective, examiner-masked, parallel-group study with 38 pediatric subjects (6 months to 12 years).
- Four administration conditions: eyedrops (open/closed eyes), spray (open/closed eyes).
- Cycloplegic efficacy measured by dynamic retinoscopy and subjective push-up at multiple time points.
Main Results:
- No statistically significant difference in cycloplegic efficacy was found among the four delivery methods (p > 0.05).
- Spray administration to the closed eye demonstrated comparable efficacy to traditional eyedrops to the open eye.
Conclusions:
- Cycloplegic spray to the closed eye is a viable and effective alternative to eyedrops.
- Spray delivery of cycloplegics may offer significant clinical advantages for pediatric eye care.
Background:
The topical administration of eyedrops is often an unpleasant procedure in the pediatric population. We sought to learn whether a combination mydriatic-cycloplegic solution would be an effective cycloplegic if delivered as a spray.
Methods:
We conducted a prospective, examiner-masked, parallel-group study and randomized 38 subjects (age range 6 months to 12 years, mean = 7.3 years) into four groups such that the same combination mydriatic-cycloplegic solution was administered under the following conditions: 1) eyedrops to eyes that were open; 2) eyedrops to eyes that were closed; 3) spray to eyes that were open; 4) spray to eyes that were closed. Both eyes of each subject received the solutions administered under one of the four conditions. Residual accommodation was measured using dynamic retinoscopy and the subjective push-up method, where applicable, at times 0, 10, 20, 30, 45, and 60 mins following administration of the medications.
Results:
Repeated measures analysis of covariance revealed no statistically significant difference (p > 0.05) in cycloplegic efficacy among the four methods of drug delivery.
Conclusions:
The results of this study suggest that administering cycloplegics by spray to the closed eye is as efficacious as instilling eyedrops to the open eye. Use of a cycloplegic spray can have important clinical advantages compared to conventional cycloplegic eyedrops administered to children.