Cycloplegics
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Cycloplegia is
paralysis Paralysis (: paralyses; also known as plegia) is a loss of Motor skill, motor function in one or more Skeletal muscle, muscles. Paralysis can also be accompanied by a loss of feeling (sensory loss) in the affected area if there is sensory d ...
of the
ciliary muscle The ciliary muscle is an intrinsic muscle of the eye formed as a ring of smooth muscleSchachar, Ronald A. (2012). "Anatomy and Physiology." (Chapter 4) . in the eye's middle layer, the uvea ( vascular layer). It controls accommodation for vie ...
of the eye, resulting in a loss of accommodation. Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects. This results in similar problems as those caused by
presbyopia Presbyopia is a physiological insufficiency of optical Accommodation (vertebrate eye), accommodation associated with the aging of the human eye, eye; it results in progressively worsening ability to focus clearly on close objects. Also known as ...
, in which the lens has lost elasticity and can also no longer focus on close-by objects. Cycloplegia with accompanying
mydriasis Mydriasis is the Pupillary dilation, dilation of the pupil, usually having a non-physiological cause, or sometimes a physiological pupillary response. Non-physiological causes of mydriasis include disease, Physical trauma, trauma, or the use of c ...
(dilation of pupil) is usually due to topical application of muscarinic antagonists such as
atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically give ...
and
cyclopentolate Cyclopentolate is a muscarinic antagonist. It is commonly used as an eye drop during pediatric eye examinations to dilate the eye (mydriatic) and prevent the eye from focusing/Accommodation (eye), accommodating (cycloplegia, cycloplegic). Cyclop ...
. Belladonna alkaloids are used for testing the error of
refraction In physics, refraction is the redirection of a wave as it passes from one transmission medium, medium to another. The redirection can be caused by the wave's change in speed or by a change in the medium. Refraction of light is the most commo ...
and examination of eye.


Management

Cycloplegic drugs are generally muscarinic receptor antagonists such as
atropine Atropine is a tropane alkaloid and anticholinergic medication used to treat certain types of nerve agent and pesticide poisonings as well as some types of slow heart rate, and to decrease saliva production during surgery. It is typically give ...
,
cyclopentolate Cyclopentolate is a muscarinic antagonist. It is commonly used as an eye drop during pediatric eye examinations to dilate the eye (mydriatic) and prevent the eye from focusing/Accommodation (eye), accommodating (cycloplegia, cycloplegic). Cyclop ...
,
homatropine Homatropine (Equipin, Isopto Homatropine) is an anticholinergic medication that is an antagonist at muscarinic acetylcholine receptors and thus the parasympathetic nervous system. It is used in eye drops as a cycloplegic (to temporarily paral ...
, scopolamine and
tropicamide Tropicamide, sold under the brand name Mydriacyl among others, is a medication used to dilate the pupil and help with the examination of the eye. Specifically it is used to help examine the back of the eye. It is applied as eye drops. Effect ...
. They are indicated for use in
cycloplegic refraction An eye examination, commonly known as an eye test, is a series of tests performed to assess vision and ability to focus on and discern objects. It also includes other tests and examinations of the eyes. Eye examinations are primarily performed ...
(to paralyze the ciliary muscle in order to determine the true refractive error of the eye) and the treatment of uveitis. All cycloplegics are also mydriatic (pupil dilating) agents and are used as such during
eye examination An eye examination, commonly known as an eye test, is a series of tests performed to assess Visual acuity, vision and ability to Focus (optics), focus on and discern objects. It also includes other tests and examinations of the human eye, eyes. ...
to better visualize the
retina The retina (; or retinas) is the innermost, photosensitivity, light-sensitive layer of tissue (biology), tissue of the eye of most vertebrates and some Mollusca, molluscs. The optics of the eye create a focus (optics), focused two-dimensional ...
. When cycloplegic drugs are used as a mydriatic to dilate the pupil, the pupil in the normal eye regains its function when the drugs are metabolized or carried away. Some cycloplegic drugs can cause dilation of the pupil for several days. The ones specifically used by ophthalmologists or optometrists wear off in hours, but when the patient leaves the office strong sunglasses are provided for comfort.


See also

* Adie syndrome *
Anisocoria Anisocoria is a condition characterized by an unequal size of the eyes' pupils. Affecting up to 20% of the population, anisocoria is often entirely harmless, but can be a sign of more serious medical problems. Causes Anisocoria is a common cond ...
* Marcus Gunn pupil *
Miosis Miosis, or myosis (), is excessive constriction of the pupil.Farlex medical dictionary
citing: ...
* Parinaud's syndrome *
Syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms depend on the stage it presents: primary, secondary, latent syphilis, latent or tertiary. The prim ...


References


External links

* * {{Mydriatics and cycloplegics Diagnostic ophthalmology Disorders of ocular muscles, binocular movement, accommodation and refraction