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Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children

PURPOSE: The aim of this study was to evaluate the factors affecting cycloplegia, as determined by pupil reactivity, in Asian children. DESIGN: Prospective observational study. METHODS: Two-hundred sixty-eight children, aged 2 to 12 years, requiring cycloplegic refraction, were recruited. Nurses ins...

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Autores principales: Lim, Jane, Chia, Audrey, Saffari, Seyed Ehsan, Handa, Swati
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727919/
https://www.ncbi.nlm.nih.gov/pubmed/31385819
http://dx.doi.org/10.1097/APO.0000000000000254
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author Lim, Jane
Chia, Audrey
Saffari, Seyed Ehsan
Handa, Swati
author_facet Lim, Jane
Chia, Audrey
Saffari, Seyed Ehsan
Handa, Swati
author_sort Lim, Jane
collection PubMed
description PURPOSE: The aim of this study was to evaluate the factors affecting cycloplegia, as determined by pupil reactivity, in Asian children. DESIGN: Prospective observational study. METHODS: Two-hundred sixty-eight children, aged 2 to 12 years, requiring cycloplegic refraction, were recruited. Nurses instilled 2 to 3 cycles of eye drops consisting of cyclopentolate 1%, tropicamide 0.5%, and phenylephrine 2.5%, and recorded the child's level of cooperation. Optometrists recorded pupil reactivity after the last cycle. Multivariate analysis determined factors affecting pupil reactivity including age, sex, race, number of eye drop cycles, pupil sizes before and after cycloplegia, and child's cooperation during eye drops instillation. RESULTS: The pupils in 36 children (13.4%) were found to be still reactive. On univariate analysis, children with reactive pupils also had smaller pupils after cycloplegia (6.27 ± 1.16 mm vs 7.42 ± 0.81 mm, P < 0.001). On multiple logistic regression analysis, for every 1-mm increase in the pupil size after cycloplegic eye drop administration, the odds of having reactive pupils decreases by 65% (odds ratio = 0.35, 95% confidence interval 0.25–0.51, P ≤ 0.001). Those who were uncooperative during administration of eye drops were 3.13 times more likely to have reactive pupils (95% confidence interval 1.21–8.13, P = 0.019), whereas age (P = 0.904), sex (P = 0.355), the number of cycles of eye drops (P = 0.462), and other psychological factors were not relevant in affecting pupil reactivity. CONCLUSIONS: Pupil reactivity, which was used as a measure of cycloplegia, was more likely to be affected by children's level of cooperation during instillation of eye drops, rather than age and sex. Two cycles of eye drops were as effective as 3 cycles in producing cycloplegia.
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spelling pubmed-67279192019-10-02 Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children Lim, Jane Chia, Audrey Saffari, Seyed Ehsan Handa, Swati Asia Pac J Ophthalmol (Phila) Original Clinical Study PURPOSE: The aim of this study was to evaluate the factors affecting cycloplegia, as determined by pupil reactivity, in Asian children. DESIGN: Prospective observational study. METHODS: Two-hundred sixty-eight children, aged 2 to 12 years, requiring cycloplegic refraction, were recruited. Nurses instilled 2 to 3 cycles of eye drops consisting of cyclopentolate 1%, tropicamide 0.5%, and phenylephrine 2.5%, and recorded the child's level of cooperation. Optometrists recorded pupil reactivity after the last cycle. Multivariate analysis determined factors affecting pupil reactivity including age, sex, race, number of eye drop cycles, pupil sizes before and after cycloplegia, and child's cooperation during eye drops instillation. RESULTS: The pupils in 36 children (13.4%) were found to be still reactive. On univariate analysis, children with reactive pupils also had smaller pupils after cycloplegia (6.27 ± 1.16 mm vs 7.42 ± 0.81 mm, P < 0.001). On multiple logistic regression analysis, for every 1-mm increase in the pupil size after cycloplegic eye drop administration, the odds of having reactive pupils decreases by 65% (odds ratio = 0.35, 95% confidence interval 0.25–0.51, P ≤ 0.001). Those who were uncooperative during administration of eye drops were 3.13 times more likely to have reactive pupils (95% confidence interval 1.21–8.13, P = 0.019), whereas age (P = 0.904), sex (P = 0.355), the number of cycles of eye drops (P = 0.462), and other psychological factors were not relevant in affecting pupil reactivity. CONCLUSIONS: Pupil reactivity, which was used as a measure of cycloplegia, was more likely to be affected by children's level of cooperation during instillation of eye drops, rather than age and sex. Two cycles of eye drops were as effective as 3 cycles in producing cycloplegia. Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong 2019-08-09 /pmc/articles/PMC6727919/ /pubmed/31385819 http://dx.doi.org/10.1097/APO.0000000000000254 Text en Copyright © 2019 Asia-Pacific Academy of Ophthalmology. Published by Wolters Kluwer Health, Inc. on behalf of the Asia-Pacific Academy of Ophthalmology. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle Original Clinical Study
Lim, Jane
Chia, Audrey
Saffari, Seyed Ehsan
Handa, Swati
Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title_full Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title_fullStr Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title_full_unstemmed Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title_short Factors Affecting Pupil Reactivity After Cycloplegia in Asian Children
title_sort factors affecting pupil reactivity after cycloplegia in asian children
topic Original Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727919/
https://www.ncbi.nlm.nih.gov/pubmed/31385819
http://dx.doi.org/10.1097/APO.0000000000000254
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