Tropicamide 1% eye drops

Introduction: Screening for ROP and its severity require optimum pupillary dilatation. Mydriatics that allow good dilatation often have systemic side effects. Topical tropicamide is considered safest but does not dilate pupils optimally. A combination of phenylephrine and tropicamide is a good mydriatic but has adverse effects. The study aims to compare the mydriatic efficacy of phenylephrine (P 2.5%) plus tropicamide (T 0.4%) versus tropicamide (T 1%) alone for ROP screening. Methods: Preterm neonates due for ROP screening were randomized to one of the two groups. One drop was instilled in the eye thrice every 15 mins. Pupillary diameter was recorded as a primary outcome measure using the Schirmer’s strip at baseline, 15, 30, and 45 minutes after drop instillation. Oxygen saturation, heart rate, and respiratory rate were measured at similar intervals. Adverse effects like apneas, vomiting, and feed intolerance were documented. Ophthalmologist comments on the visibility of different retinal zones were also recorded. Data were analyzed by t-test and Chi-square test as appropriate. Results: Fifty-four preterm babies were included (27 in each group). The birth weight (1130 ± 300g, 1220 ± 460 g) and gestation (34.40 ± 2.26 and 34.74 ± 3.24) weeks were similar in both groups. The pupillary size after 45 minutes in group 1 (7.56 ± 1.12 mm) was significantly greater (P < 0.001) than that of group 2 (5.92 ± 0.90 mm). The visibility of retinal zones was better in group 1 compared to group 2, which was statistically significant (P < 0.01). There was no significant difference between the two groups in saturation, heart rate, and respiratory rate at 30 mins and 45 mins. Conclusion: A combination of phenylephrine and tropicamide is a more effective mydriatic with no increase in adverse effects.

Abstract licence: CC BY-NC-SA 4.0

Abstract Objectives: To assess and compare the effects of tropicamide 0.5% and tropicamide 1% on intraocular pressure (IOP) and pupil diameter (PD) in patients with diabetes mellitus. Methods : A total of 98 eyes of 98 diabetic patients were included in this double-masked randomized clinical trial. Patients were randomly assigned to receive either tropicamide 0.5% (49 eyes) or tropicamide 1% (49 eyes). IOP was measured by Goldmann applanation tonometry; PD was measured by Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany), before and 30 min after tropicamide administration. Results: Mean PD change and IOP change was 2.99 ± 0.62 mm and 0.12 ± 1.71 mm Hg in tropicamide 0.5% group, and was 3.11 ± 0.55 mm and 0.25 ± 1.70 mm Hg in tropicamide 1% group, with no significant difference (P = 0.31, P = 0.72, respectively). No participants had IOP increase of 5 mm Hg or more. Conclusion: The effect of tropicamide 0.5% and tropicamide 1% drops on IOP and PD was similar. Mydriasis with tropicamide did not result in significant IOP change.

Abstract licence: CC BY 4.0

Background: Clozapine-induced hypersalivation (CIH) affects 30–80% of patients on clozapine therapy and is a significant driver of treatment non-adherence. Current management options, predominantly systemic anticholinergics, risk compounding other clozapine-related adverse effects. Topical tropicamide 1% eye drops, repurposed for sublingual administration, represent a potentially safer, cost-effective alternative. Aim: To report the efficacy and tolerability of sublingual tropicamide 1% eye drops for CIH across seven patients with schizophrenia or treatment-resistant schizophrenia (TRS). Methods: A retrospective case series of seven patients who received tropicamide 1% ophthalmic solution (4–8 drops/day) sublingually for CIH. Improvement was assessed by patient-reported percentage reduction in salivation. Results: All seven patients reported meaningful improvement (25–80%). The only adverse effect was a transient bitter taste in one patient. No systemic anticholinergic side effects were recorded. Conclusion: Sublingual tropicamide appears well-tolerated and cost-effective for managing CIH. Its short duration of action, low systemic absorption via the sublingual mucosa, and M4 muscarinic receptor antagonism offer potential advantages over existing treatments. Randomised controlled trials are warranted.

Abstract licence: CC BY 4.0

BackgroundMyopia has emerged as a major threat to the visual health of adolescents worldwide. Early intervention can effectively slow down the progression of myopia in adolescents. Tuina (also known as Tui Na), a significant therapeutic method in traditional Chinese medicine, has shown promising clinical efficacy in delaying the progression of myopia; however, it lacks robust, large-scale, and standardized randomized controlled trials.ObjectiveThis study aims to explore the efficacy and safety of tuina therapy in managing myopia in adolescents, thereby providing solid evidence for the application of tuina in the clinical treatment of myopia.MethodsThis study is a multicenter randomized controlled clinical trial. A total of 62 children with myopia will be recruited from 4 hospitals and randomly assigned in a 1:1 ratio to a tuina experimental group and a drug-positive control group (tropicamide eye drops). Treatments in each group will be administered 3 times per week for a total of 8 weeks. The tuina experimental group will receive 20 minutes of tuina therapy per session, while the drug-positive control group will receive tropicamide eye drops administered every other day, with 2 drops per session. The primary outcome measures include uncorrected visual acuity and axial length, while secondary outcome measures include refractive power and accommodative amplitude. Data will be collected at baseline (week 0), on the day of completion of weeks 4 and 8 of treatment, and at the end of the 10-week follow-up period. Adverse events will be monitored and recorded throughout the study. Statisticians will be blinded. Data will be analyzed using SPSS version 28.0.ResultsThis study has been funded, and recruitment began in June 2025. As of December 2025, 29 participants have been enrolled, with 16 allocated to the tuina group and 13 to the drug-positive control group. Recruitment is expected to continue until October 2026. Final manuscript submission is anticipated by December 2026.ConclusionsThis study aims to evaluate the efficacy and safety of tuina therapy in the treatment of adolescents with myopia. We hypothesize that the therapeutic effect of tuina therapy is noninferior to that of tropicamide eye drops, with the additional advantages of fewer side effects and stable long-term efficacy, thereby providing reliable evidence and support for the application of tuina therapy in the management of myopia in adolescents.

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PurposeTo assess retinal and choroidal changes following rapid mydriasis in healthy adults.MethodsSeventy-one volunteers (71 right eyes) participated in a prospective randomised controlled trial. They were divided into two groups: tropicamide (n=36) and a mixture (tropicamide:phenylephrine=1:1, n=35) groups. Ophthalmic examinations included visual acuity, intraocular pressure and axial length measurements. Ultra-widefield swept-source optical coherence tomography angiography was used to assess retinal and choroidal parameters before and after mydriasis. This technique covers a 24×20 mm² area, allowing for non-invasive, simultaneous structural and haemodynamic assessment of retinal and choroidal regions.ResultsBoth central (tropicamide: 33.3%; mixture: 22.22%) and mid-peripheral (tropicamide: 28.47%; mixture: 36.81%) retinas thickened slightly postmydriasis (p>0.05, FDR corrected).ConclusionsRapid mydriasis causes slight retinal thickening, the slight change in the outer layer, particularly in the temporal and inferior regions. There were no significant changes in the choroid parameters following mydriasis, except for choroidal stroma volume. The limitation of this study was the small sample size and the absence of a control group.

Abstract licence: CC BY-NC