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Getting your eyes dilated can be inconvenient – dilation makes your eyes light sensitive, which can make it difficult to read books or use phones and computers for a few 4 hours.
So wouldn’t it be great to have another drop to reverse the effects of dilation?
On Dec. 31, 1990, dapiprazole, under the trade name Rev-Eyes, was approved by the FDA and thought to be the answer to all the post-dilation problems. It was marketed for treatment of medically-induced dilation by stimulating pupillary constriction and restoration of accommodative function for reading.
In clinical practice, dapiprazole took between one to two hours to return pupils to pre-dilation size.
Side effects such as stinging upon instillation, conjunctival hyperemia (redness of eye), headache, and a few instances of ptosis (lid drooping), with a possible additional dollar cost to patients, seemed to lessen dapiprazole’s overall clinical benefit.
Reading ability returned in approximately 43 minutes with dapiprazole vs 66 minutes without the drop (Optom Vis Sci 1994 May; 71(5):319-22). The main complaint that people had after using dapiprazole was the conjunctival hyperemia, which lasted more than three hours. The other issue was that dapiprazole was costly, so some practitioners included an additional charge for the reversal of dilation to offset the cost.
The full adverse reaction profile according to Drugs.com is as follows:
"Adverse Reactions: In controlled studies, the most frequent reaction to dapiprazole was conjunctival injection lasting 20 minutes in over 80% of patients. Burning on instillation of dapiprazole hydrochloride ophthalmic solution was reported in approximately half of all patients. Reactions occurring in 10% to 40% of patients included ptosis, lid erythema, lid edema, chemosis, itching, punctate keratitis, corneal edema, browache, photophobia and headaches. Other reactions reported less frequently included dryness of eyes, tearing and blurring of vision."
Currently, Rev-Eyes is off the market. The FDA has stated that Rev-Eyes was not withdrawn from the market for reasons of safety or effectiveness.
At this time, there is nothing available for reversal of dilation. People who get dilated will still need to wear their sunglasses and to put off reading for a couple of hours until the effects of the dilation drops wear off.
Article contributed by Dr. Jane Pan
This blog provides general information and discussion about eye health and related subjects. The words and other content provided on this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.
We are frequently asked if it’s wise to have cataract surgery if you have Macular Degeneration.
Let’s start with some background.
- Cataracts and Age-related Macular Degeneration (AMD) are both leading causes of visual impairment in the elderly population.
- Cataracts develop when the normal clear lens gets cloudy with age. This is correctable with cataract surgery, which involves replacing the cloudy lens with a clear, artificial lens.
- While cataracts affect the front part of the eye, AMD causes damage to the retina, which is the inner back lining of the eye.
There have been concerns about cataract surgery causing progression of AMD. It has been thought that there was an inflammatory component to AMD and the normal inflammatory response after cataract surgery may lead to AMD progression.
But studies have looked at patients who underwent cataract surgery compared to patients who didn't have cataract surgery and the progression of AMD was not significantly different between the two groups. However, those patients with AMD who underwent cataract surgery had a significant improvement in vision.
AMD patients can further be characterized as having wet or dry AMD, and only those with wet AMD require treatment. Patients with wet AMD need injections to decrease the growth of new blood vessels and reduce fluid in the retina.
A 2015 study showed that after cataract surgery, there was an increase in fluid in the retina of patients with wet AMD. Therefore, in patients with wet AMD, we usually want the wet AMD to be stabilized before the patient has cataract surgery. Sometimes an injection may be given prior to cataract surgery to prevent any inflammatory changes that may be associated with cataract surgery.
The majority of the studies on the subject conclude that it is relatively safe to have cataract surgery even if you have AMD and in most cases there is a significant improvement in vision. Removing the cloudy lens also helps the ophthalmologist to better monitor the status of the AMD. You will want to have a candid discussion with your eye doctor on the timing, benefits, and potential risks of cataract surgery with macular degeneration.
Article contributed by Dr. Jan Pan.
This blog provides general information and discussion about eye health and related subjects. The words and other content provided in this blog, and in any linked materials, are not intended and should not be construed as medical advice. If the reader or any other person has a medical concern, he or she should consult with an appropriately licensed physician. The content of this blog cannot be reproduced or duplicated without the express written consent of Eye IQ.
