Abstract

PurposeTo evaluate the effect of brimonidine tartrate 0.025% ophthalmic solution on pupil size under scotopic conditions in healthy adultsMethodsPupil size was measured in 56 eyes of 28 volunteer participants using a pupillometer under scotopic conditions. Age, gender, and iris color were recorded. Subjects using any ophthalmic medications other than artificial tears were excluded. The pupil size was subsequently measured again under scotopic conditions 60 min after instillation of brimonidine tartrate 0.025% ophthalmic solution.ResultsStatistically significant miosis was seen after instillation of brimonidine tartrate 0.025% (p = 0.04). Average pupil size prior to brimonidine 0.025% instillation was 7.28 ± 1.05 mm, and average pupil size after instillation of brimonidine 0.025% was 6.36 ± 1.68 mm, a reduction of − 23.7% in pupil area. Subjects with light irides demonstrated a greater miotic effect than subjects with dark irides (1.55 mm vs. 0.67 mm, p < 0.0001), with a pupil area reduction of − 37.6% and − 17.4%, respectively. The amount of miosis was independent of initial pupil size.ConclusionsBrimonidine tartrate 0.025% causes significant miosis in scotopic settings, although the effect is not as great in darker colored eyes. Further studies are needed to determine the latency and duration of the effect and whether the amount of miosis is clinically significant.

Highlights

  • Brimonidine tartrate 0.025% ophthalmic solution, a selective alpha-2 adrenergic receptor agonist, is FDA-approved for relieving redness of the eye

  • Laser in situ keratomileusis can induce spherical aberration and nighttime halos due to discrepancies between the optical zone and scotopic pupil size, and these aberrations and distortions have been effectively treated with pharmacologic miosis [9, 10]

  • The overall pupil size after instillation of brimonidine 0.025% decreased significantly from 7.28 to 6.36 mm, a difference in pupil area of − 23.7% (p < 0.0001)

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Summary

Introduction

Brimonidine tartrate 0.025% ophthalmic solution, a selective alpha-2 adrenergic receptor agonist, is FDA-approved for relieving redness of the eye. It has been available for overthe-counter use in the USA as Lumify® (Bausch & Lomb) since 2018. Pupillary constriction has been shown to be an effective treatment for positive dysphotopsias after cataract surgery. These undesired light streaks, starburst, arcs, and flashes are caused by light striking the edge of the intraocular lens implant and may potentially be dampened by decreasing the size of the pupil [11]

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