Effects of Scopolamine Patches on Pupil and Accommodation

ABSTRACT

Scopolamine Patch is transdermal drug delivery system that contains 1.5mg of scopolamine This agent is used for prevention of motion sickness, but a few partients note dilated pupils and complain of difficulty in near work in the use of the patches. The cause of pupil dilation and cycloplegia from scopolamine patches has been thought to be a result of ocular contamination from handling of the patches, but there was no definitive proof. Moreover, the duration and amplitudes of mydriasis and cycloplegia from this patches have not been fully described. The authors studied the effects of the scopolamine patches on pupil size and accommodative amplitude. The results were as follows 1. Mydriasis and cycloplegia from scopolamine patchs were not results of systemic absorption, but of ocular contamination from finger which already touched to the patches. 2. The maximal pupil dilation was observed in all age groups between 1+1/2 and 4 hours after contamination, and its effect lasted 3 to 5 days. 3. The maximal reduction of the accommodative amplitude was observed at 4 hours after contamination and the reduction of the accommodative amplitude was statistically significant in older age group(p>0.05). 4. Return to original pupil size or miosis and recovery from the reduction of the accomodative amplitude were observed in 40%, 50%, and 71%, respectively by the first day on instillation of 1%, 2% and 4% pilocarpine.