title: Pupil dilation using drops vs gel: a comparative study.
abstract: OBJECTIVE
  To compare the efficacy in pupil dilation and degree of discomfort between topical instillation of mydriatic drops and gel.
  
  
  METHODS
  The study included 60 patients with no previous ocular history of trauma and surgery. One eye was dilated with two drops (tropicamide 0.5% and phenylephrine 10%), and the other with one drop of gel (tropicamide 0.5%+phenylephrine 5%). Pupil size was measured by a Colvard pupillometer at baseline and 5, 15, 30, and 45 min following instillation. Pain upon instillation was measured by visual analog scale (VAS).
  
  
  RESULTS
  There was no difference in pupil size at baseline. Use of the gel achieved greater mydriasis than drops (P=0.01), and was also associated with lower pain scores (P=0.003). In diabetic patients, pupil size was smaller at baseline and following instillation of drops and gel. Use of the gel achieved an even greater degree of pupil dilation in this subset of patients than drops (P=0.019).
  
  
  CONCLUSIONS
  Gel formulation achieved significantly greater pupil dilation than drops, despite a lower concentration of phenylephrine, and was also associated with significantly lower patient discomfort. This study is the first report of improved mydriatic efficacy in diabetic patients.
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: E
authors: E
authors: Moisseiev
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: D
authors: D
authors: Loberman
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: E
authors: E
authors: Zunz
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: A
authors: A
authors: Kesler
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: A
authors: A
authors: Loewenstein
authors: Department of Ophthalmology, Tel Aviv Sourasky Medical Center, Affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors: J
authors: J
authors: Mandelblum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications; D004338:Drug Combinations; D058447:Eye Pain / Q000175:diagnosis; D005260:Female; D005782:Gels; D006801:Humans; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions / Q000008:administration & dosage; D010147:Pain Measurement; D010656:Phenylephrine / Q000008:administration & dosage*; D011680:Pupil / Q000187:drug effects*; D014331:Tropicamide / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D004338:Drug Combinations; D005782:Gels; D009184:Mydriatics; D009883:Ophthalmic Solutions; D010656:Phenylephrine; D014331:Tropicamide