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ARTICLE
Year : 1958  |  Volume : 6  |  Issue : 1  |  Page : 13-14

Phenyl-ephrine hydrochloride in ophthalmology


King Edward Memorial Hospital, Bombay, India

Date of Web Publication8-May-2008

Correspondence Address:
D G Mody
King Edward Memorial Hospital, Bombay
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Mody D G, Saroya. Phenyl-ephrine hydrochloride in ophthalmology. Indian J Ophthalmol 1958;6:13-4

How to cite this URL:
Mody D G, Saroya. Phenyl-ephrine hydrochloride in ophthalmology. Indian J Ophthalmol [serial online] 1958 [cited 2020 May 27];6:13-4. Available from: http://www.ijo.in/text.asp?1958/6/1/13/40714

Table 1

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Table 1

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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.[5]

 
  References Top

1.
Goodman, L. and Gilman, A. : The pharmacological basis of Therapeutics; MacMillan Co., New York (1941), P• 475.  Back to cited text no. 1
    
2.
Heath, (1936), Arch. of Ophth. 16, 839  Back to cited text no. 2
    
3.
Post, W. L., (1937), Amer. J. Ophth 20, 170.  Back to cited text no. 3
    
4.
Sugar, H. S. : The Glaucomas; C. V. Mosby Co., St. Louis, (1951), p. 250  Back to cited text no. 4
    
5.
Weekers, R. : In Symposium on Glau­coma, Blackwell Scientific Publications. Oxford, (1955), p. 267.  Back to cited text no. 5
    



 
 
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