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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/07/21 18:46:24」(JST)

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Cycloplegia is paralysis of the ciliary muscle of the eye, resulting in a loss of accommodation.^[1] Because of the paralysis of the ciliary muscle, the curvature of the lens can no longer be adjusted to focus on nearby objects. This results in similar problems as those caused by presbyopia, in which the lens has lost elasticity and can also no longer focus on close-by objects. Cycloplegia with accompanying mydriasis (dilation of pupil) is usually due to topical application of muscarinic antagonists such as atropine and cyclopentolate.

Anatomy

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)
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 noradrenergic receptors by the sympathetic nervous system.

Cycloplegic drugs

Cycloplegic drugs are generally muscarinic receptor blockers. These include atropine, cyclopentolate, homatropine, scopolamine and tropicamide. They are indicated for use in cycloplegic refraction (to paralyze the ciliary muscle in order to determine the true refractive error of the eye) and the treatment of uveitis. All cycloplegics are also mydriatic (pupil dilating) agents and are used as such during eye examination to better visualize the retina.

When cycloplegic drugs are used as a mydriatic 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 or optometrists wear off in hours, but when the patient leaves the office strong sunglasses are provided for comfort.

References

^ "cycloplegia" at Dorland's Medical Dictionary

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English Journal

Racial variations in the prevalence of refractive errors in the United States: the multi-ethnic study of atherosclerosis.

Pan CW, Klein BE, Cotch MF, Shrager S, Klein R, Folsom A, Kronmal R, Shea SJ, Burke GL, Saw SM, Wong TY.SourceSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
American journal of ophthalmology.Am J Ophthalmol.2013 Jun;155(6):1129-1138.e1. doi: 10.1016/j.ajo.2013.01.009. Epub 2013 Feb 27.
PURPOSE: To describe racial variations in the prevalence of refractive errors among adult white, Chinese, Hispanic, and black subjects in the United States.DESIGN: Cross-sectional data from a prospective cohort study-the Multi-Ethnic Study of Atherosclerosis (MESA).METHODS: A total of 6000 adults ag
PMID 23453694

A Prospective Comparison Between Cyclopentolate Spray and Drops in Pediatric Outpatients.

Syrimi M, Jones SM, Thompson GM.AbstractPURPOSE:To determine whether children tolerate cyclopentolate 1% spray better than drops and to assess the adequacy of cycloplegia achieved by spray for objective refraction. METHODS:The effects of cyclopentolate 1% drops and spray on distress levels were assessed prospectively using a guardian questionnaire in consecutive patients 10 years of age or younger. Distress was graded at various points during the appointment using a Likert scale of 1 to 10 (1 = no distress, 10 = severe distress). The adequacy of cycloplegia in children receiving cyclopentolate spray and the waiting times were assessed via a Likert questionnaire completed by the examining physician. RESULTS:The guardians of 72 and 77 children who received cyclopentolate 1% drops or spray, respectively, completed the questionnaire. The children were divided in three age groups: 1 to 4 years, 5 to 7 years, and 8 to 10 years. Children 7 years or younger were significantly less distressed by administration of cyclopentolate 1% spray (P < .005). There was no statistical difference in distress levels in children older than 7 years (P = .9719). Thirteen of the 77 children who received cyclopentolate 1% spray did not have adequate cycloplegia to allow objective refraction. CONCLUSION:The results demonstrate cyclopentolate 1% spray is less distressing at the time of administration than cyclopentolate 1% drops for children 7 years or younger. However, the cycloplegia achieved is not adequate in a high percentage of children.[J Pediatr Ophthalmol Strabismus 20XX;XX(X):XX-XX.].
Journal of pediatric ophthalmology and strabismus.J Pediatr Ophthalmol Strabismus.2013 May 28:1-6. doi: 10.3928/01913913-20130521-01. [Epub ahead of print]
PURPOSE:To determine whether children tolerate cyclopentolate 1% spray better than drops and to assess the adequacy of cycloplegia achieved by spray for objective refraction. METHODS:The effects of cyclopentolate 1% drops and spray on distress levels were assessed prospectively using a guardian ques
PMID 23705592

Japanese Journal

Prevalence of Eye Diseases and Causes of Visual Impairment in School-Aged Children in Western China

PI Lian-Hong,CHEN Lin,LIU Qin,KE Ning,FANG Jing,ZHANG Shu,XIAO Jun,YE Wei-Jiang,XIONG Yan,SHI Hui,ZHOU Xi-Yuan,YIN Zheng-Qin
Journal of epidemiology 22(1), 37-44, 2012-01-01
… We conducted door-to-door surveys and eye examinations including optometry, stereoscopic vision test, eye position and eye movement, slit lamp examination of the anterior segment, retinoscopy, and fundus examination after cycloplegia with 1% cyclopentolate.<BR>Results: Among 3469 children, data were available for 3079 (88.76%). …
NAID 10030213040

イヌの屈折検査におけるハンディオートレフラクトメーターの信頼性、および調節麻痺の影響

伊藤良樹,萩原雅俊,前原誠也,泉澤康晴
比較眼科研究 30(0), 3-10, 2011
獣医眼科学における屈折検査にはレチノスコープが主に用いられており、オートレフラクトメーターを用いた屈折検査の報告はほとんど無い。本研究では、イヌの眼に対するハンディオートレフラクトメーターの信頼性、および調節麻痺が屈折検査結果に与える影響について検討した。レチノスコープとオートレフラクトメーター（Retinomax K-plus; Nikon）を用い、23頭46眼の実験ビーグルの眼屈折度（球面度数 …
NAID 130003378086

近視矯正でのコツ (特集コンタクトレンズ診療)

宇津見義一,高田義明
眼科 51(13), 1751-1755, 2009-12
NAID 40016903358

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★リンクテーブル★

リンク元	「cycloplegic」「調節麻痺」「毛様体筋麻痺」

「cycloplegic」

Cycloplegia
	Dilated pupil (mydriasis) caused by Cyclopentolate 1% instilled into both eyes
Classification and external resources
ICD-10	H52.5
ICD-9-CM	367.51
DiseasesDB	17379