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September 1981

Mydriatic Solution for Indirect Ophthalmoscopy-Reply

Arch Ophthalmol. 1981;99(9):1654. doi:10.1001/archopht.1981.03930020528029

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In Reply.  —We are indebted to the reminder by Drs Apt and Henrick of Fraunfelder's important contribution to ocular pharmacology in which the efficacy of a drug concentration is improved by use of a "pouch method" that increases corneal contact time and reduces dilution by tears.Our study was conducted using the older fashion of drug instillation into the inferior cul-de-sac, and, as with the study by Apt and Henrick, after the instillation of proparacaine 0.5% and pneumatonography. It is entirely probable that their emphasis on the "pouch technique" explains the adequate mydriasis found with lower concentrations of tropicamide and phenylephrine. The reason we did not use the method of Fraunfelder was mainly lethargy and inertia.In our efforts to optimize medication concentrations and the therapeutic-risk ratio, we should all be reminded of Dr Fraunfelder's recommendation for the technique of instilling medications and to reaffirm our efforts to educate

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