Efficacy of Conjunctival Application Using Cotton-tipped Applicator for Mydriasis and Cycloplegia

ABSTRACT

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.