Effects of dilation using Homatropine + LED light exposure

[silentblasphemy]

Hi Dr. Hagan,

I went for my 6 monthly regular retina and vitreous check as usual. My regular doctor was out so his colleague and his team did the exam. The actual exam was fine as usual. However, here is the problem - The dilating drops this new doctor used were not Tropicamide but Homatropine. I only found later on this forum that the effect of these particular drops can last upto a week.

1. It's been 2 days and still the near vision is not back to full (the drops have not worn off).  I wear dark, UV tinted glasses when I go outside in the sunlight but sometimes the reflecting sunlight from cars and the street does go into my unprotected eye. Is that going to be a problem of solar retinopathy given that the pupil was dilated and reflected sunlight is entering the dilated eye?

2. I started seeing halos around bright lights in the apartment complex that I live in. I first noticed the halo around a quite bright 40W LED light. I wanted to know what exactly I was seeing (since it was completely new) so I accidentally ended up staring at the LED light from a distance of 5-6 feet for about 20-25 seconds. My question is -  if such 40 Watt LED lights contain UV rays like the sun, and if my eyes were dilated, it means the harmful rays would enter my eye with full force. I did see an afterimage for about a minute and then it disappeared. Can this lead to either thermal or photochemical damage to the retina? Any latent damage?

Overall, my experience with Homatropine was quite bad and I will stick to Tropicamide next time. I am particularly worried about point 2, the LED light, since I looked directly into it.

[John C Hagan III, MD, FACS, FAAO]

First of all I would call your  regular doctor and complaint.  In a routine eye examination there is no reason to ever use homatropine. I used it last week on an emergency with iritis and scars from the iris to the lens.  But routine exam NO WAY>  Then I would call the doctor that used the homatropine and make a formal complaint and ask for an explanation why he/she put you through this misery.  No way to predict how long the drops will last. Depends on the amount that got in your eye, the concentration of the drops (I believe homatropine comes in 2 and 5%)  the color of your eyes (will wear off much faster in brown eyes and last much longer in blue/gray/green) and lastly how fast your body metabolizes the medicine.     For 1. no solar retinopathy will not be a problem. wear hat, sunglasses and you can buy the wrap around UV blocking sun shields that we use after cataract surgery and that many people like for bright light and reflection off snow or water.  2.  Short answer is 'no'  longer answer is that when the drops have finally worn off things should be back to normal.

Again don't forget the complaints to both eye doctors.  We never use homatropine for routine exam.  and if patients tell us the drops last a long time we use only one set of drops or only one kind of drop  (we use 2.5% neosynephrine and/or 1% tropicamide).   (we sometimes use 0.5% tropic)

[silentblasphemy]

Thanks for the quick & detailed response Dr. Hagan. I really appreciate it. I am very particular about my eye health and have already made an official complaint to my regular doctor. I have also given a very bad, publicly accessible review to the attending doctor on our country's top portal for Doctors.

The drops were 2% (I called them to ask) , and my eyes are brown in color. I am just going to avoid going out as much as I can for the next week as I have the week off anyway.

Final follow up questions - 1. Some posts on the internet say that high intensity LED lights may have UV rays..that is why I was worried (I stared directly into it with pupils open wide). Should I stop worrying about this entirely?

2. Can I continue aerobic exercise (running) and drink alcohol in moderation till the drops wear off (or will that hinder the metabolization of the drops)?

Thanks once again and warm regards, Doctor Hagan.

[John C Hagan III, MD, FACS, FAAO]

1. No momentarily won't hurt your eyes.  2.  yes (or course wear eye protection if running or drinking outside.  3. Drink responsibly.

[silentblasphemy]

Thanks Doctor Hagan once again for being a great human being.

[John C Hagan III, MD, FACS, FAAO]

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