A Comparison of the Mydriatic Efficacy of Tropicamide and Phenylephrine Eye Drops Administered as a Vaporized Spray in One Eye and Conventional Drop Instillation in the Other Eye in an Indian Pediatric Cohort.

Purpose: To determine by serial measurements and compare the pupillary mydriasis effect of tropicamide and phenylephrine drops administered as a vaporized spray over closed lids in one eye and through conventional instillation of eye drops in the other eye in a pediatric cohort. Methods: This prospective study was conducted on healthy children aged 6-15 years. After visual assessment, investigator 1 examined the child for initial pupillary size. Investigator 2 instilled the drops in one eye and applied the spray to the other eye randomly, and the response of the child was noted using the Wong-Baker pain rating scale. The eyes receiving the spray and the eyes receiving drop instillation were considered as Groups 1 and 2, respectively. Subsequently, serial pupillary measurements were carried out every 10 min for up to 40 min by investigator 1. The patient compliance for the two methods of drug instillation was also compared. Results: The study comprised 80 eyes. At 40 min, both the groups showed no statistical difference in the mydriasis effect, with Group 1 showing 7.23 mm mydriasis and Group 2 showing 7.58 mm (P = 0.058). The analysis of the pain rating scale showed better compliance with the spray method of drug instillation, which was statistically significant (P = 0.044). Conclusions: Our study shows that spray application is a less invasive method for pupillary dilatation, which has better compliance and provides equally good dilatation as conventional methods. This study proves the efficacy of spray application in an Indian pediatric cohort.

Periocular dirofilariasis: A case series.

OBJECTIVE: To cite a series of patients presenting with complaints of a lid swelling associated with preseptal cellulitis. METHODS: Three patients on three different occasions came with complaints of a unilateral lid swelling associated with preseptal cellulitis. Examination showed palpable mass in the upper eyelid localized, firm in consistency and was freely mobile and occasionally disappeared during palpation. CT scan showed nonspecific preseptal inflammation. A trial of antibiotics was given in each of the cases with temporary reduction in the swelling but a consecutive flare up following which patient was subjected to excision biopsy. Each of the biopsies was subjected to histopathological and microbiological examination. RESULTS: On excision biopsy in all the three cases it was reported to be a parasitic infestation belonging to the genus Dirofilaria. CONCLUSIONS: Dirofilariaiasis is a common zoonotic infection among wild animals but rarely infects human beings with ocular involvement. Hence dirofilariasis should be considered as a differential diagnosis for migratory subcutaneous swellings and conjunctival nodules in the southern belt of India.