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To the Editor.
—We read with interest the article "Mydriatic Solution for Outpatient Indirect Ophthalmoscopy" in the Archives (1980;98:1572-1574) by Sinclair et al. Their results support our findings reported earlier (Am J Ophthalmol 1980;89:553-559), which, apparently, the authors did not have the opportunity to see during the processing of their manuscript.Sinclair and co-workers found that a combination of 5% phenylephrine with 0.8% tropicamide was necessary to obtain an adequate mydriasis ("6 mm or more") that resisted the intense illumination of indirect ophthalmoscopy. They also found that mydriasis was less resistant to intense illumination when the concentration of tropicamide in the mixture was reduced to 0.5%. However, we obtained wide pupillary dilation (6 mm or more) that was sustained during indirect ophthalmoscopy with lower concentrations of the same two mydriatics in a mixture, ie, 2.5% phenylephrine with 0.5% tropicamide. In addition, we found that mydriasis was further enhanced when the
Apt L, Henrick A. Mydriatic Solution for Indirect Ophthalmoscopy. Arch Ophthalmol. 1981;99(9):1654. doi:10.1001/archopht.1981.03930020528028