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Efficacy of a mydriatic spray in the pediatric population
J O Benavides1, E R Satchell, K A Frantz
1Illinois College of Optometry, Chicago, USA.
Insights
Mydriatic sprays applied to closed eyelids are as effective as traditional eye drops for dilating children's pupils. This method offers a potentially more comfortable alternative for pediatric fundus examinations.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Pharmacology
Background:
- Pediatric fundus evaluation often faces challenges due to children's resistance to eye drop instillation.
- Cycloplegic sprays have emerged as a viable alternative for drug delivery in pediatric care.
Purpose of the Study:
- To evaluate the efficacy of a mydriatic spray compared to traditional mydriatic eye drops in a pediatric population.
- To determine if mydriatic sprays are a suitable alternative for achieving pupil dilation in children.
Main Methods:
- A study involving 22 healthy children aged 2-8 years.
- Comparison of one drop each of 1% tropicamide and 2.5% phenylephrine versus a mydriatic spray (0.5% tropicamide, 2.5% phenylephrine) applied to closed eyelids.
- Pupil size was measured at baseline and every 10 minutes for 40 minutes post-administration.
Main Results:
- Both mydriatic drops and sprays significantly increased pupil size over time (p < 0.0005).
- No statistically significant difference in pupil size was observed between the spray and drop methods at 40 minutes (p > 0.05).
- No significant method/time interaction was found, indicating consistent efficacy over time for both methods.
Conclusions:
- Mydriatic sprays applied to closed eyelids demonstrate comparable efficacy to mydriatic eye drops in open eyes for pediatric pupil dilation.
- This suggests mydriatic sprays are a practical and effective alternative for fundus examinations in children.
- The findings support the use of mydriatic sprays to improve patient comfort and compliance during ophthalmic assessments.
Background:
Children often resist instillation of mydriatic drops for dilated fundus evaluation. As cycloplegic sprays have proven useful, this study's aim was to demonstrate efficacy of a mydriatic spray.
Methods:
Twenty-two healthy subjects, ages 2 to 8 years, participated in the study. All but two had dark brown irides. Subjects were given either one drop each of 1% tropicamide and 2.5% phenylephrine in each eye or one application of mydriatic spray (containing concentrations of 0.5% tropicamide and 2.5% phenylephrine) to each closed eyelid. Pupils were measured with a pupil gauge before drug delivery and every 10 min thereafter, for 40 min.
Results:
Repeated measures analysis of variance for the five time intervals demonstrated no significant difference between the two application methods nor in the method/time interaction, but a statistically significant increase in pupil size over time (p < 0.0005) for each method. A t-test revealed no statistically significant difference in pupil size (p > 0.05) between the two methods of drug administration at 40 min after application.
Conclusions:
This study suggests that use of mydriatic sprays on closed eyelids is as efficacious as use of mydriatic drops in open eyes for children.