PURPOSE: We tried to evaluate the reliablility of refractive measurement by hand-held autorefractor (HHAR). METHODS: Ninety patients (180 eyes) with simple refractive error were divided into three groups (30 patients each) according to their ages. Group I is under 6 years old; group II, from 7 to 15 years old; and group 3, over 16 years old. Under cycloplegics, three measuring methods of refraction using table top autorefractor (Model 599, Zeiss Humphrey, USA), hand-held autorefractor (Retinomax K-plus, Nikon, Japan) and skiascope (Heine beta 200, Germany) were performed and we compared each spherical and cylindrical value in 3 groups. RESULTS: There was no significant difference in both spherical and cylindrical value between HH-AR and skiascope in all groups (PI, sph=0.579, PI, cyl=0.708, PII, sph=0.801, PII , cyl=0.730, PIII , sph=0.816, PIII, cyl=0.754) . But there was significant difference in both spherical and cylindrical value between table top autorefractor and skiascope in group I (PI,sph=0.019, PI,cyl=0.030, PII,sph=0.405, PII,cyl=0.392, PIII,sph=0.876, PIII,cyl=0.747). CONCLUSIONS: We believe that hand-held autorefractor can be a useful instrument to measure refractive power without serious error, especially in patients who have difficulty with table top autorefractor.
Adolescent ; Child ; Humans ; Mydriatics ; Refractive Errors

The therapeutic applications of Soft Contact Lenses including its optical use are most popular, devices in Ophthalmological field. The presoaked soft contact lenses (Bionite Lens) by 1% pilocarpine,10% phenylnephrine. 1% homatropine, and 1% atropine for 4 minutes are inserted into the albino rabbit and the size of pupil was measured using mm. caliper under the dim red light in the dark room. Hourly measurements were carried out and were stopped in each subject when the pupil size of both eyes had returned to normal. The pupil size of control group, which only the above drug were instilled into the conjunctival cuI de sac, was also measured as the same method. As conclusion using soft contact lens in the therapeutic purpose, it potentiate the effect of medication and prolong the time of drug effect compared with the control groups.
Atropine ; Contact Lenses, Hydrophilic* ; Miotics* ; Mydriatics* ; Pupil

We compared the differences of the intraocular pressure measured by the applanation and the Schiotz tonometer according to the ocular rigidity and its changes. We also did it by sex difference, age and the ocular rigidity range. The Korean 254 normal eyes, 12 aphakic eyes, 32 mydriatics treated eyes and 102 myopic eyes were examined. The intraocular perssure was measured by Goldmann applanation tonometer and Schiotz indentation tonometer using the 5.5 gram and 10.0 gram plunger load successively. The ocular rigidity was estimated from the Moses and Becker table. The results were as follows: 1. The mean ocular rigidity of the male and the female Korean was 0.0157 and 0.0195, respectively. There was no significant differences between the two tonometric values. 2. There was no significant ocular rigidity changes according to ages, and there was no statistically significant differences between the two tonometric values, 3. There was no statistically significant differences between the two tonometric values according to the ocular rigidity range. 4. The mean ocular rigidity of normal eyes, aphakic eyes. mydriatics treated eyes and myopic eyes was 0.0183 0.0166, 0.0164 and 0.0170, respectively, and there was no significant differences between the two tonometric values in each groups.
Female ; Humans ; Intraocular Pressure ; Male ; Manometry* ; Mydriatics ; Sex Characteristics

The hypotony with cyclodialysis after blunt trauma to the eye rarely happens and the cyclodialysis is diagnosed by finding the cleft in the anterior chamber anglel It is treated with cycloplegics conservatively or with surgery. In this study, the authors reviewed the hyphema, the onset of hypotony, the size of cyclodialysis cleft and transient scleral buckling that is one of the surgery in 7 eyes of 7 patients . The hyphema was seen in all cases after blunt trauma to the eyes and the duration between the trauma and the onset of hypotony was average 7.2 days. The traumatic cyclodialyses clefts were half an clock hour in 3 patients and 1 to 4 clock hours in 4 patients . Six patients had an initial conservative treatment, 3 patients required surgical treatment, scleral buckling, for 3 weeks for the full recovery of intraocular pressure.
Anterior Chamber ; Humans ; Hyphema ; Intraocular Pressure ; Mydriatics ; Scleral Buckling

Usual managements of flat anterior chamber following filtering surgery are deepening of anterior chamber using cycloplegics and mydriatics, and pressure patch technique compressing the fistula. But the pressure patch technique may worsen chamber depth problem because exact compression on the filtering area is difficult by pressure patching. Prolonged pressure patching may also cause deterioration of filtering function. The tampon with glaucoma shell provides enough resistance to excessive outflow, allows the anterior chamber to reform promptly, and can prevent choroidal separation. We treated the flat anterior chamber following trabeculectomy using glaucoma shell in 7 eyes. The anterior chamber in each eye was restored promptly within 2-4 days after the placement of glaucoma shell. Glaucoma shell is easy to handle, gives minimal discomfort to patient, and may need less time to restore flat anterior chamber than pressure patching.
Anterior Chamber* ; Choroid ; Filtering Surgery ; Fistula ; Glaucoma* ; Humans ; Mydriatics ; Trabeculectomy*

PURPOSE: To report a case of acute angle closure after cataract surgery using an accommodative intraocular lens (IOL), WIOL-CF® (GELMED, Praha, Czech). CASE SUMMARY: A 46-year-old male patient underwent phacoemulsification and implantation of WIOL-CF® into the capsular bag. Seven months after the surgery, a sudden increase in intraocular pressure (IOP) associated with angle closure was observed. Ultrabiomicroscopy revealed a dislocated WIOL-CF® that was pushing the peripheral iris anteriorly. Despite the use of IOP-lowering medication and peripheral laser iridotomy, IOP was not controlled. After the use of cycloplegics, the angle was widened and IOP decreased; however, after nine days, the WIOL-CF® was completely dislocated into the anterior chamber and so was removed. CONCLUSIONS: When performing cataract surgery using WIOL-CF®, a possibility of dislocation of IOL and subsequent angle closure should be considered.
Anterior Chamber ; Cataract ; Dislocations* ; Glaucoma ; Humans ; Intraocular Pressure ; Iris ; Lenses, Intraocular* ; Male ; Middle Aged ; Mydriatics ; Phacoemulsification

Cyclodialysis with hypotony is defined as a rare disorder that meridional ciliary muscle is disinserted from its attachment at the scleral spur due to trauma or intraocula surgery such as extracapsular cataract extraction with or without intraocular lens implantation, iridectomy, and etc. Its managements include conservative therapy with cycloplegics, and surgical treatment such as argon laser photocoagulation, cyclopexy, and diathermy. The authors diagnosed cyclodialysis cleft by observing clinical features and finding of the cleft in the anterior chamber angle with gonioscopy. The cyclodialysis cleft with hypotony has been treated with argon laser photocoagulation into the cleft area.
Anterior Chamber ; Argon* ; Cataract Extraction ; Diathermy ; Gonioscopy ; Iridectomy ; Lens Implantation, Intraocular ; Light Coagulation* ; Mydriatics

PURPOSE: We compared the efficacy of applying mydriatics to the conjunctiva of the lower eyelid by using a cotton-tipped applicator with an eye-dropping method. METHODS: Thirty children under 16 years of age (60 eyes) and 30 adults more than 20 years old (60 eyes) were randomly chosen. Mydriatics were applied to each eye using an eye-dropping method for one eye and a conjunctival application method using a cotton-tipped applicator for the other eye. Pupil size was measured before applying mydriatics, immediately and at 30 and 60 minutes after application. Also, we investigated the degree of discomfort. RESULTS: In the children, the pupil size in the eye dropping group and the conjunctival application group were each 8.01+/-0.57 mm and 7.97+/-0.57 mm at 60 minutes after applying mydriatics (P=0.07). In the adults, the pupil size was 7.94+/-0.59 mm in the eye-dropping group and 7.89+/-0.55 mm in the conjunctival application group at 60 minutes after applying mydriatics (P=0.074). In terms of degree of discomfort, the adults found the conjunctival application method to be significantly more unpleasant than the eye-dropping method at each three applications (P=0.001, 0.001, 0.001). CONCLUSIONS: The conjunctival application method using a cotton-tipped applicator has an equal effect in terms of mydriasis compared to the eye-dropping method. It is convenient to use in children and in the elderly who show less compliance. Also, this new method reduces systemic absorption of the medication. Therefore, the conjunctival application method is a good substitute for the conventional methods for mydriasis.
Absorption ; Adult ; Aged ; Child ; Compliance ; Conjunctiva ; Eye ; Eyelids ; Humans ; Mydriasis ; Mydriatics ; Pupil

As the number of diabetic patient increases, it is important to manage diabetic retinopathy. Clinically sufficient pupillary dilatation should be obtained for fundoscopic examination and laser photocoagulation theraphy of diabetic patient but we experienced insufficient and delayed pupillary dilatation after instillation of mydriatics. In order to examine abnormality of pupillary dilatation and its relationship to the stage of diabetic retiniopathy, the course of pupillary diameter was measured with Haab's pupillometer after instillation of one drop of 1% Mydriacyl(R) and 2.5% Mydfrin(R) in 72 patients with diabetes mellitus (40-69 years old) and 11 normal controls (40-69 years old). The following results were obtained. After instillation of 1% Mydracy(R), the maximum pupillary diameter was smaller in diabetic retinopathy group than in controls. As the severity of diabetic retinopathy was increased, maximum pupillary diameter was decreased. After instillation of 2.5% Mydfrin(R), the delay of the average time to reach maximal mydriasis in diabetic group was larger than that in controls. This delay was proportional to the severity of diabetic retinopathy. Therefore it was considered that the abservation of the course of pupillary diameter after instillation of mydriatics would be useful for diagnosis of the severity of diabetic retinopathy.
Diabetes Mellitus ; Diabetic Retinopathy* ; Diagnosis ; Dilatation* ; Humans ; Light Coagulation ; Mydriasis ; Mydriatics*

PURPOSE: To evaluate the changes of higher-order aberrations of the eye with the application of various mydriatics. METHODS: Higher-order aberrations were measured in 18 eyes of 11 subjects (ages 26 to 37 years; 9 males, 2 females) without any ocular diseases except refractive errors. Repeated measurements were conducted before and after instillation of 1 drop of three different mydriatics: 10% phenylephrine, a combination of 0.5% tropicamide and 0.5% phenylephrine (Mydrin(R)-P), and 1% cyclopentolate. The data from 6 mm pupil size were calculated and analyzed. RESULTS: Average root mean square of higher-order (HO-RMS) aberrations was 0.39 in undilated eyes. The averages HO-RMS after instillation of phenylephrine, Mydrin(R)-P, and cyclopentolate was 0.40, 0.41, and 0.42, respectively. There was no statistically significant difference among the four HO-RMS conditions. The spherical aberration of undilated or phenylephrine-instilled condition was different from that of Mydrin(R)-P or cyclopentolate condition (p<0.05). CONCLUSIONS: The application of mydriatics affected the higher-order aberrations of eyes. These findings should be considered when performing wavefront-guided refractive surgery.
Cyclopentolate ; Humans ; Male ; Mydriatics* ; Phenylephrine ; Pupil ; Refractive Errors ; Refractive Surgical Procedures ; Tropicamide