Corneal Sensitivity and Treatments

Questions and Answers

What is the primary purpose of using anesthetics prior to administering other eye drops?

To reduce corneal sensitivity (correct)

To prevent intraocular pressure spikes

To improve visual acuity

To enhance anesthetic effect

Which condition is NOT indicated for the use of anesthetics?

Before administration of other drops

Corneal foreign body or injury

Post-surgical corneal healing (correct)

Intraocular pressure measurement for glaucoma suspect

What of the following statements is true about Tropicamide?

Retinal detachment

Prolonged pupil dilation

Vitreous hemorrhage

Rarely causes CNS disturbance (correct)

At what concentration is Tropicamide recommended for children younger than 1 year?

0.5% Signup and view all the answers

Which of the following is true concerning Phenylephrine HCl?

2.5% is the maximum recommended dose. Signup and view all the answers

Why should 10% Phenylephrine not be used?

It can lead to acute hypertension. Signup and view all the answers

What is a key characteristic of proparacaine as an anesthetic?

It helps in transporting other agents across the cornea. Signup and view all the answers

What onset time is typical for Tropicamide?

15-30 minutes Signup and view all the answers

What is the primary purpose of Atropine in infants aged 3 months and older?

To induce pupil dilation and cycloplegia Signup and view all the answers

Which concentration of Cyclopentolate should be administered to an infant under 1 year of age?

0.5% Signup and view all the answers

Which population may exhibit hypersensitivity to cholinergic antagonists when using Cycloplegics?

Children with Down syndrome or spastic paralysis Signup and view all the answers

What is a common central sign of Atropine toxicity?

Confusional psychosis Signup and view all the answers

What is the typical duration of cycloplegia when Cyclopentolate is administered?

6-8 hours Signup and view all the answers

Which ocular side effect is associated with the use of Atropine?

Blurred near vision Signup and view all the answers

What is the recommended administration protocol for Cyclopentolate in children?

Two drops separated by 5 minutes Signup and view all the answers

In case of Atropine toxicity, which antidote is known to counteract the effects?

Physostigmine salicylate Signup and view all the answers

What is a common cardiovascular effect of Atropine toxicity?

Tachycardia Signup and view all the answers

Which medication is FDA approved for myopia management?

Misight Signup and view all the answers

What is the primary reason for using 1% phenyl in children with Down syndrome?

They have a lower accommodation level, reducing the need for high dosages. Signup and view all the answers

Which of the following is a key differentiator between cyclopentolate and tropicamide?

Cyclopentolate has a stronger cycloplegic effect. Signup and view all the answers

What are the ocular side effects associated with cycloplegics?

Photophobia, blurred near vision, and pupil dilation. Signup and view all the answers

Which dosage should be used in a healthy 7-month-old infant for cyclopentolate?

0.5% cyclopentolate, 2 drops 5 minutes apart. Signup and view all the answers

When is it indicated to use cyclopentolate first in the treatment regimen?

During amblyogenic dry retinoscopy procedures. Signup and view all the answers

Why is atropine rarely recommended for first-time cycloplegic patients?

It lasts longer than necessary and poses more side effects. Signup and view all the answers

Which of the following statements is true regarding the use of 1% tropicamide?

It has fewer adverse effects compared to atropine. Signup and view all the answers

What dosage of cyclopentolate is appropriate for a 3-year-old child with esotropia who did not respond to previous dilation?

1% atropine at bedtime for 3 nights. Signup and view all the answers

Study Notes

Anesthetics and Corneal Procedures

Decrease corneal sensitivity, enhancing comfort before administering other drops.
Improve transport of other agents across the cornea for better efficacy.
Indicated for corneal foreign body, injury, and tonometry in glaucoma suspects.
Common anesthetics: 0.5%/1% proparacaine and 0.4% benoxinate, may include fluorescein dye.
Use anesthetics in children to minimize discomfort from stinging.

Tropicamide

A muscarinic antagonist that paralyzes the iris sphincter and ciliary muscle.
Available concentrations: 0.5% and 1.0%; 0.5% used for children under 1 year and those with lighter irides.
Onset of action: 15-30 minutes; duration: 4-6 hours with limited cycloplegic effect (suitable for albinism).
Rare side effects may include central nervous system disturbances.

Phenylephrine HCl

Exhibits no cycloplegic effect; typically used in a 2.5% solution.
Maximum dosage: 2 drops spaced 5 minutes apart; caution advised in children with cardiovascular issues.
1% concentration is considered safe for infants; avoid 10% solution.
Paremyd combines 0.25% tropicamide with 1.0% p-hydroxyamphetamine.

Atropine

Muscarinic antagonist approved for use in children aged 3 months and older for dilation and cycloplegia.
Available concentrations: 0.5% for light irides; 1.0% for darker ones.
Administer as ointment or drops at bedtime for three nights prior to exam; onset: 3-6 hours; lasts from 1 to 2 weeks.
Side effects can include photophobia, blurred near vision, and systemic toxicity symptoms.

Atropine Toxicity

Peripheral symptoms: dry mucous membranes, tachycardia, gastrointestinal issues, urinary retention.
Central symptoms: neurologic dysfunction, confusion, hallucinations; overdose can lead to severe outcomes such as convulsions.
Education for parents on side effects is crucial for safety.

Cyclopentolate

Another muscarinic antagonist used for cycloplegia; concentrations vary based on age.
Dosage: 0.5% for under 1 year and 1.0% for over 1 year, with 2 drops spaced 5 minutes apart.
Maximum cycloplegia occurs at 40 minutes, with a total duration of effect lasting up to 24 hours.
Commonly preferred for shorter action compared to atropine, but can still cause significant side effects.

General Use Recommendations

Tropicamide and cyclopentolate are typically the first choices for pediatric patients.
Review specific protocols for different age groups and conditions, such as Down syndrome and amblyopia management.
Careful monitoring for adverse effects in all patients, especially in vulnerable populations like infants and those with pre-existing conditions.

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Description

This quiz explores the effects of various agents on corneal sensitivity and their roles in treating corneal injuries and conditions. It covers indications for the use of drops, particularly before administering other medications and in cases of foreign bodies or tonometry for glaucoma. Test your knowledge on eye care and ocular medication.