Levine L
Am J Optom Physiol Opt. 1976 Dec;53(12):774-85. doi: 10.1097/00006324-197612000-00004.
The mydriatic effects of several concentrations of phenylephrine and of tropicamide were studied in 84 young adults for 90 min following topical instillation. Pupillary diameter was estimated (a) under ambient photopic illumination and (b) when illumination was increased to that associated with direct ophthalmoscopy. Evaluation was made of the "degree of mydriasis," i.e., the difference in pupillary diameter between the eye receiving the mydriatic agent and the contralateral control eye when the pupillary light reflex was stimulated. In subjects with light or hazel irides, phenylephrine caused maximal dilatation in 60 to 75 min, mean values being 5.6 mm with 1 drop of 2%, 6.0 mm with 2 drops of 2.5%, and 7.1 mm with 1 drop of 10%. Maxiumum degrees of mydriasis were 3.0 mm with 2 drops of 2.5% and 3.1 mm with 1 drop of 10%. With 0.5% tropicamide, maximum diameter was 8.0 mm in 30 min in subjects with light, hazel, or brown irides, and the maximum degree of mydriasis was 5.0 mm. It is concluded that when a mydriatic agent is used to facilitate intraocular visualization, neither specification in terms of (a) maximum diameter under ambient illumination nor (b) degree of mydriasis provides optimal characterization. It is suggested that the "clinically effective diameter," i.e., pupillary diameter under illumination corresponding to that to be used during examination, would be the most useful specification.
对84名年轻成年人局部滴入几种浓度的去氧肾上腺素和托吡卡胺后90分钟内的散瞳效果进行了研究。分别在（a）环境明视照明下和（b）照明增加至直接检眼镜检查相关照明时估计瞳孔直径。对“散瞳程度”进行评估，即当刺激瞳孔对光反射时，接受散瞳剂的眼睛与对侧对照眼之间瞳孔直径的差异。在虹膜颜色浅或呈淡褐色的受试者中，去氧肾上腺素在60至75分钟时引起最大扩张，1滴2%溶液时平均值为5.6毫米，2滴2.5%溶液时为6.0毫米，1滴10%溶液时为7.1毫米。最大散瞳程度在2滴2.5%溶液时为3.0毫米，1滴10%溶液时为3.1毫米。使用0.5%托吡卡胺时，虹膜颜色浅、呈淡褐色或褐色的受试者在30分钟时最大直径为8.0毫米，最大散瞳程度为5.0毫米。结论是，当使用散瞳剂以利于眼内观察时，无论是（a）环境照明下的最大直径还是（b）散瞳程度都不能提供最佳特征描述。建议“临床有效直径”，即在与检查期间所用照明相对应的照明下的瞳孔直径，将是最有用的特征描述。
