AUTONOMIC DRUGS

Act on sphincter & dilator pupillae muscle of the iris & also on the ciliary muscle. They are 

• miotics- pupil constricting
• Mydriatic- pupil dialating
• Cycloplegic- drugs causing paralysis of accommodation.

MIOTICS

Systematically morphine is a strong miotics.

TOPICAL MIOTICS:- 

A. Cholinergic drugs are there types:- 

1. Direct stimulant:- pilocarpine (1%-4%) 
2. Indirect stimulant:- eserine (0.25% - 1%)
3. Combination:- direct & indirect action, e.g -carbachol, urecholine.

USE:- 

⭐ GLAUCOMA - @POAG; @PACG

⭐ Treatment of accommodation convergent squint.

⭐ Useful in accommodative weakness.

⭐ During cataract surgery; PCIOL= After placing; ACIOL= Before placing.

MYDRIATIC

Systematically used atropine caused pupillary dilatation.

Pupil dilating drugs are called mydriatics. Alldrugs which dilate the pupil also paralyze the accommodation in greater or lesser degree, due to paralysis of the ciliary muscles (cycloplegia).

TOPICAL 

@PARASYMPATHOLYTIC MYDRIATIC:- 

• Atropine (1%)
• Homatropine (1-2%)
• Cyclopentolate (0.5%- 1%)
• Tropicamide (0.5%- 1%)

@SYMPATHOMIMETIC MYDRIATIC:- 

• Phenylephrine drop (2.5% - 10%)

⭐ Atropine is the strongest cycloplegic agents & the effects least for 10-14 days.

⭐ Homatropine is moderately effective and it's effects least for only 48-72 hours.

⭐ Cyclopentolate & tropicamide are very rapidly drug,the effects of which lasts for only for 12-24 hours.

USES OF MYDRIATIC:- 

1. Fundus examination
2. Preoperative assessment of cataract
3. During cataract or posterior segment surgery
4. To break posterior synechiae (along with cycloplegic)
5. Uveitis

USE OF CYCLOPLEGIC:- 

1. For perfect refraction in children, hypermetropic subject & in squint. 
2. Refraction in case where very small pupil.
3. Incase of iridocyclitis, keratitis & endophthalmitis.
4. In accommodative convergent squint.
5. In case of accommodation spasm.
6. Penalization treatment in amblyopia.

ATROPINE:- 

• Myatro 0.01%
• Kidtro 
• Atropine 1%
• Tropin
• Topin

HOMATROPINE:- 

• Homied
• Homacid
• Mydryn
• HA2

CYCLOPENTOLATE:-

• Cyclogyl
• Cyclomid