|Year : 1958 | Volume
| Issue : 1 | Page : 13-14
Phenyl-ephrine hydrochloride in ophthalmology
DG Mody, Saroya
King Edward Memorial Hospital, Bombay, India
|Date of Web Publication||8-May-2008|
D G Mody
King Edward Memorial Hospital, Bombay
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mody D G, Saroya. Phenyl-ephrine hydrochloride in ophthalmology. Indian J Ophthalmol 1958;6:13-4
Phenyl-ephrine hydrochloride or Neosynephrine is a synthetic sympathomimetic compound.
It is a very useful agent in ophthalmology. It is used for its decongestive, mydriatic and tension lowering effects. Stronger solutions (2.5 to 10%) produce a prompt and short acting mydriasis almost entirely free from cycloplegia. It remains stable for long periods in high concentrations, an advantage over epinephrine.
Decongestion : A 1% solution was shown by Heath (1936) to prevent the oedema produced by mustard oil. We have observed rapid absorption of conjunctival oedema following instillation of 1 and 10% emulsions. It also helps to relieve the itching, smarting and watering that may be associated. For angio-neurotic oedema a 10% emulsion is massaged into the skin of the lids.
Mydriasis : The following table gives a comparison of the mydriatic and cycloplegic effect of phenylephrine hydrochloride and other mydriatics. [Table - 1].
The mydriasis produced by neosynephrine is prompt in action, the10% emulsion being more efficient than any other preparation tried by Heath in the dilatation of pupils resistant to atropine. Combined with homatropin it offers the maximal pupil dilatation for viewing the peripheral fundus in retinal separation and for breaking the synechiae in uveitis.
Like adrenalin, it can be used in combination with a mydriatic or a local anaesthetic to enhance the action of these drugs.
Effect on Intraocular Tension : Occasional slight increases of tension were observed by W. Post (1937) but these were never marked, while in most cases the tension was lowered 4-5 mm. Hg. In two eyes with initial tension of 30-32 mm. this drop in tension amounted to from 11-13 mm. Hg.
According to Weekers (1954) a 2% solution of adrenalin (1 drop every two days) keeps the tension well down in cases of chronic simple glaucoma. Since a 2% solution of adrenalin is not available, we have tried a 2% solution of neosynephrine and we have observed that it is possible to keep the tension well under control with preservation of the field over long periods (2 years). Sugar has suggested the use of ¼% neosynephrine in combination with strong miotics such as physostigmine in congestive attacks of glaucoma.
Surgery : 30-60 minutes before operation, 2.5-10% solution may be applied for dilatation of the pupils, before intraocular surgery especially cataract extration. We have used it with good results as the mydriasis produced is of very short duration, and miosis is ensured soon after the incision.
| References|| |
Goodman, L. and Gilman, A. : The pharmacological basis of Therapeutics; MacMillan Co., New York (1941), P• 475.
Heath, (1936), Arch. of Ophth. 16, 839
Post, W. L., (1937), Amer. J. Ophth 20, 170.
Sugar, H. S. : The Glaucomas; C. V. Mosby Co., St. Louis, (1951), p. 250
Weekers, R. : In Symposium on Glaucoma, Blackwell Scientific Publications. Oxford, (1955), p. 267.
[Table - 1]