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- paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation
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Extensive Definition
Cycloplegia is paralysis of the ciliary
muscle of the eye,
resulting in a loss of accommodation.
The iris is the heavily pigmented colored part of the eye. It has a
contractile diaphragm in front of the lens with a central opening
called the pupil. It is located between the lens and the cornea,
and is attached radially to the ciliary body and the cornea via
ligaments called pectinate ligaments. The iris contains two sets of
muscles: a radial group for enlargement of the pupil (dilator
pupillae), and a circular group set to decrease pupil size on
contraction (sphincter pupillae). The muscles regulate the amount
of light entering the eye. The sphincter pupillae is stimulated
through muscarinic receptors by the parasympathetic nervous system.
The dilator pupillae is stimulated through adrenergic receptors by
the sympathetic nervous system.
Cycloplegic drugs are generally muscarinic
receptor blockers. These include atropine, cyclopentolate, homatropine, scopolamine and tropicamide. They are
indicated for use in cycloplegic refractions and the treatment
of uveitis. Many
cycloplegics are also mydriatic (pupil dilating)
agents and are used as such during
ophthalmoscopic examinations to better visualize the retina.
Destruction of the sphincter pupillae from any
cause can result in a permanent condition, called "photophobia."
Light entering an eye with a paralyzed or destroyed sphincter will
result in severe pain, because the pupil can not be made
smaller.
When cycloplegic drugs are used to dilate the
pupil, the pupil in the normal eye regains its function when the
drugs are metabolized or carried away. Some cycloplegic drugs can
cause dilation of the pupil for several days. Usually the ones used
by ophthalmologists wear off in hours, but when the patient leaves
the office strong sunglasses are provided for comfort. Anyone who
has had their retina examined with the prior use of cycloplegic
drugs is aware of this phenomenon. It is a disorder which mainly
occurs as a side effect for muscarinic agonists like
ach,pilocarpine,physostigmine,etc..