A double-blind study comparing 0.5% and 1% tropicamide for annual retinal screening in diabetic adolescents

Aims  To determine whether there is any difference between 0.5% and 1% tropicamide in ocular discomfort and mydriatic efficacy in adolescents with Type 1 diabetes. Methods  In a double‐blind study, one drop of 0.5% tropicamide was instilled in one eye and one drop of 1% instilled in the other eye of...

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Bibliographic Details
Published in:Diabetic medicine 2004-05, Vol.21 (5), p.434-439
Main Authors: Hassler-Hurst, J., Wadham, C., Rayman, G.
Format: Article
Language:English
Subjects:
Adolescent
Biological and medical sciences
Child
diabetes mellitus
Diabetes Mellitus, Type 1
Diabetes. Impaired glucose tolerance
Diabetic Retinopathy - diagnosis
Dose-Response Relationship, Drug
Double-Blind Method
Endocrine pancreas. Apud cells (diseases)
Endocrinopathies
Female
Humans
Male
mass screening
Mass Screening - methods
Medical sciences
Mydriatics - administration & dosage
Mydriatics - adverse effects
ophthalmoscopy
Ophthalmoscopy - methods
Pain - chemically induced
Pain Measurement - methods
Patient Compliance
Pupil - drug effects
tropicamide
Tropicamide - administration & dosage
Tropicamide - adverse effects
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Summary:Aims  To determine whether there is any difference between 0.5% and 1% tropicamide in ocular discomfort and mydriatic efficacy in adolescents with Type 1 diabetes. Methods  In a double‐blind study, one drop of 0.5% tropicamide was instilled in one eye and one drop of 1% instilled in the other eye of 30 subjects aged 12–18 years. Drop strengths were randomized. Pupil size was measured before instillation, at 10, 20 and 30 min. Discomfort was measured using a recognized pain scale. Results  Irrespective of the concentration of tropicamide used, all pupils dilated to at least 6 mm at 30 min, sufficient for successful ophthalmoscopy. Pain was significantly less when the lower concentration of tropicamide was used; pain score for the 0.5% group [median (interquartile range)] 1.0 (0–2) and 2.0 (1–3) for the 1.0% group, P = 0.009 (Wilcoxon rank test). Conclusions  This minor change in practice significantly reduces the distress associated with drop instillation without compromising the clinical examination, and may thus be important in encouraging compliance at the yearly diabetic review. Diabet. Med. (2004)
ISSN:0742-3071
1464-5491
DOI:10.1111/j.1464-5491.2004.01172.x