This study investigated the difference in pupillary dilation between a normal dose and a substandard dose of a topical ophthalmic mydriatic agent, the combination of hydroxyamphetamine hydrobromide 1% and tropicamide 0.25% (Paremyd™ solution). The manufacturer's recommended dosage is 1-2 drops per eye. A typical opthalmic drop ranges in volume from 30 - 75. We hypothesized that a small, substandard dose of 10 will create a pupillary dilation clinically and statistically equivalent to that of the larger, standard dose of 30 in part due to the reflex tear response and increased lacrimal drainage. Our research found that the smaller dose of the mydriatic does indeed provide a clinically and statistically equivalent pupillary dilation to the larger dose. Clinically, the use of a reduced dose of a topical mydriatic will reduce the inherent risks and side effects to the patient (especially to the high-risk patient), while still allowing the eye care practitioner ample pupillary dilation to provide a quality dilated fundus examination.
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