Abstract
Purpose To compare the efficacy and side effects of two combinations of tropicamide and phenylephrine as mydriatics for ophthalmoscopy. Methods In this prospective randomized controlled trial, 51 Chinese outpatients were randomized to receive topical tropicamide 1.0% and phenylephrine 2.5% (Regime A), and 50 to receive a fixed combination of tropicamide 0.5% and phenylephrine 0.5% (Regime B). The change in horizontal pupillary diameter, subject discomfort upon instillation and the time elapsed between instillation and recovery from glare and near blur were studied. Results After 60 minutes, the mean increase in pupillary diameter was 3.56±0.65 mm with Regime A, and 3.04±0.62 mm with Regime B ( P<0.01), but there was no difference in the proportion of subjects having a post-mydriatic pupillary diameter of 6 mm or larger ( P=0.54). No subjects required additional instillation. Regime B was better tolerated ( P<0.001). The median times elapsed between instillation and recovery from glare or near blur was 7 hours, without a significant difference between the two regimes ( P=0.5). Conclusions Both regimes were effective and safe for ophthalmoscopy. However, Regime B was better tolerated. Subjects may be reassured that the side effects of glare and near blur are likely to disappear by the following day.
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