Atropine not dilating pupils much

[BramSki]

My eyes are dropped with atropinesulfate 1% now every day for 1 week now. But when I shine bright LED light into my eyes my pupils still react a little to the light and constrict for 1mm.

So I was wondering wjy my pupils arent dilated for maximum size...and still react to bright light a little..

Will atropine dilate the pupil to its maximum size when dropping them everyday? And what do I need todo to get the pupil to it's maximum dilated size, and not reacting to light. I also got some 1% Cyclogyl drops.

[BramSki]

And by the way!

I wish you a happy new year, and a healthy 2012, Dr. O. !

Also I'm very happy you are so helpful Dr. O. You seem to be very interested in answering my questions and doing research on the effects of Eye medicine. I've always been doing research by myself, on medicine I got presribed for all day use. Such as Ritalin, Atropine, Cyclopentolate.

And the eye is a very complex part of the human body, which brings alot of new knowledge everyday. All this knowledge in accomplished by studying the effects of medicines etc on millions of patients. That is why I'm very happy to bring you the knowledge of the effects of several medicines on myself. Also I hope you can answer and investigate most of the questions I ask. Even tho my English isn't always perfect, we can still understand each other.

At this moment I noticed some effects of my Eyedrops which I'd like to discuss with you Dr. O.

Let me just explain the whole situation first, and list my current medicines below.

List of my daily-use medicines:
- Methylphenidate Hydrochloride ( 10 Milligrams, 3 Times a Day )
- Atropinesulfate 1% ( 1-2 Drops in both eyes, 1 Time a Day )
- Cyclopentolate Hydrochloride 1 % ( 2 Drops in both Eyes, When I think needed )

You said those eyedrops only cause 'Mid pupil dilation' which I assume to be a dilation of 6mm. This 'Mid pupil dilation' is the maximum possible when only the actions of the 'Sphincter Muscle' is blocked. Maximum pupil dilation can only be reached when both the 'Sphincter Muscle' and 'Dilator Pupillea Muscle' are affected. Although it seems my pupils are already past 'Mid pupil dilation', and I assume this is caused by the Stimulation of my Ritalin on the 'Dilator Pupillea Muscle' which in combination of my Atropine cause dilation past 'Mid pupil dilation'. Could you please confirm or explain what causes my pupils to dilate past 'Mid pupil dilation'.

[BramSki]

Thanks you!

So my eyedrops, Atropine and Cyclopentolate only affect specific receptors that causes a blockage of the Sphincter Pupillea, which then relaxes and causes the Pupil to dilate.

Which would be a dilation of maximum 6mm, cause the second muscle which I will call 'Dilator Muscle' can still perform actions. Although when Atropine or Cyclopentolate is applied in combination with Neosynephrine both Muscles will lose function causing the Pupil to dilate past mid dilation.

But I've got another interesting questionfor you Doctor. I have Ritalin for my ADHD, and I was wondering when I use Atropine to relax my eyes which causes Mid Pupil dilation. Will the effects of the Ritalin cause bigger pupil dilation? Cause Ritalin stimulates the 'Dilator Muscle' if I'm right?

[Ray T Oyakawa, MD]

There are two muscles that dilate your pupil. Atropine, Cyclogyl, cyclopentalate, mydriacyl, etc block the action of one muscle group, causing mid pupil dilation.  Neosynephrine acts on another muscle group to dilate the pupil past mid dilation.

Dr. O.

[BramSki]

And can you may explain me why Atropine does not Dilate the pupil to maximum size and make them not reacting to light? Cause I'm very curious why it doesnt.

[BramSki]

I also have Cyclopentolate 1% drops. Will the pupil reach maximum size when using Cyclogyl and Atropine together?

[BramSki]

I'm having Atropine and Cyclogyl to treat my accommodationspasm, and was just doing some research about the effects of these drops. And noticed that Atropine is not  dilating my pupils to the max..

Although my pupils are dilated to a huge size, and are barely responding to light, but I was just wondering why my eyes  weren't fully dilated and not responding to light.

Do you may know how strong the pupils dilation of Atropine will be when used everyday. I'm using them everyday now for about a week, and will need to continue it for the next 3 weeks. And why do my eyes still react to light? And why does atropine not dilate them to the maximum?

[Ray T Oyakawa, MD]

You need to add neosynephrine to dilate the pupil to maximum size.  Why are you dilating your pupils?

Dr. O