Mydriatic Eye Drops and Eye Fatigue: Key Concerns

Q: Mydriatic Eye Drops and Eye Fatigue: Key Concerns

Hello： 1. There is no contraindication. A ten-minute interval is sufficient. 2. It could possibly be trigeminal neuralgia. 3. Some individuals may respond more slowly, which does not necessarily indicate a problem.

Pupil-dilating eye drops, eye fatigue issues?

Hello Doctor: I am a patient with high myopia, with a prescription of -750 diopters in my right eye and -700 diopters in my left eye.
I also experience floaters in both eyes, and I have a history of a retinal tear in my left eye, along with thinning of the retina in my right eye.
I have three questions for you:
(1) Recently, I visited an ophthalmologist due to discomfort in my eyes, and the doctor prescribed Tropicamide eye drops for dilation, to be used twice daily.
Previously, another ophthalmologist prescribed Neostigmine Methylsulfate eye drops, suggesting I use them if I feel eye fatigue.
However, I found that the ingredients in these two medications seem to be incompatible.
Can they be used together, or how long should I wait between using them?
(2) I often feel a tight, pressure-like sensation deep in my right eye, near the inner corner, which makes me want to rub the area around my eyebrows to relieve it.
Occasionally, this is accompanied by a right-sided headache.
During these times, I apply the aforementioned eye drops, but there is not much improvement.
Could this be due to ciliary muscle tension caused by eye strain? My intraocular pressure checks during regular ophthalmology visits have consistently shown no issues.
(3) Due to my previous retinal tear in the left eye, I tend to be more anxious and seek dilation examinations whenever I notice any abnormalities in my vision.
However, I have recently noticed that the effect of the dilation drops seems to take longer to kick in; on one occasion, I even had to apply the drops twice before my pupils adequately dilated.
Am I developing a tolerance to the dilation drops, or could it be that my eyes were too fatigued during those days, making dilation more difficult? Thank you for your patient response!

Mo, 20~29 year old female. Ask Date: 2022/10/30

Dr. Gao Pilin reply Ophthalmology

Hello: 1.
There is no contraindication.
A ten-minute interval is sufficient.
2.
It could possibly be trigeminal neuralgia.
3.
Some individuals may respond more slowly, which does not necessarily indicate a problem.

Reply Date: 2022/10/30

More Info

Hello! Thank you for your detailed questions regarding your eye health and the use of mydriatic eye drops. Let's address each of your concerns systematically.

1. Combination of Tropicamide and Neostigmine Methylsulfate: Tropicamide is a mydriatic agent commonly used to dilate the pupils for examination purposes, while Neostigmine Methylsulfate is a medication that can help with eye fatigue by enhancing the function of the ciliary muscle, which is responsible for focusing. While these two medications have different mechanisms of action, they can be used together, but it is essential to space them out. Generally, it is advisable to wait at least 15-30 minutes between using different eye drops to allow each medication to absorb properly and minimize any potential interaction. However, since you are under the care of an ophthalmologist, it is best to follow their specific recommendations regarding the timing and combination of these medications.

2. Eye Fatigue and Ciliary Muscle Tension: The sensation of tightness or pressure in your right eye, especially accompanied by headaches, could indeed be related to eye fatigue or strain. This is often seen in individuals who have high myopia or those who spend prolonged periods focusing on near tasks, such as reading or using screens. The ciliary muscle, which controls the shape of the lens for focusing, can become fatigued, leading to discomfort. If the eye drops you mentioned do not provide relief, it may be beneficial to implement some lifestyle changes, such as the 20-20-20 rule: every 20 minutes, take a 20-second break to look at something 20 feet away. Additionally, ensure that you are using proper lighting and ergonomics when engaging in close work to reduce strain.

3. Response to Mydriatic Agents: If you have noticed that the mydriatic drops are taking longer to work or require more frequent applications to achieve the desired effect, this could be due to several factors. It is not common to develop a tolerance to mydriatic agents like Tropicamide, but individual responses can vary based on factors such as fatigue, hydration levels, and overall eye health. If your eyes are particularly fatigued, this could potentially affect how quickly the drops take effect. It is also worth noting that if you are experiencing significant eye fatigue, it may be beneficial to address that issue first, as reducing fatigue could improve the effectiveness of the drops.
In summary, managing eye fatigue is crucial, especially for someone with high myopia and a history of retinal issues. Regular check-ups with your ophthalmologist are essential, particularly given your history of retinal tears. They can provide tailored advice and adjust your treatment plan as necessary. If you continue to experience discomfort or if your symptoms worsen, do not hesitate to reach out to your eye care provider for further evaluation.
Maintaining good eye health involves not only the appropriate use of medications but also lifestyle adjustments to reduce strain and fatigue. Regular breaks, proper lighting, and hydration can all contribute to better eye comfort and function. Thank you for your questions, and I hope this information helps clarify your concerns!

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