CD 013260

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Topical mydriatics as adjunctive therapy for traumatic iridocyclitis

(Review)
Hom J, Sarwar S, Kaleem MA, Messina CR, Abariga SA, Nguyen QD
Hom J, Sarwar S, Kaleem MA, Messina CR, Abariga SA, Nguyen QD.
Topical mydriatics as adjunctive therapy for traumatic iridocyclitis.
Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD013260.
DOI: 10.1002/14651858.CD013260.pub2.
www.cochranelibrary.com
Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review)

Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Cochrane Trusted evidence.
Informed decisions.
Library Better health. Cochrane Database of Systematic Reviews
TABLE OF CONTENTS
HEADER......................................................................................................................................................................................................... 1
ABSTRACT..................................................................................................................................................................................................... 1
PLAIN LANGUAGE SUMMARY....................................................................................................................................................................... 2
BACKGROUND.............................................................................................................................................................................................. 3
OBJECTIVES.................................................................................................................................................................................................. 3
METHODS..................................................................................................................................................................................................... 4
Figure 1.................................................................................................................................................................................................. 5
RESULTS........................................................................................................................................................................................................ 7
DISCUSSION.................................................................................................................................................................................................. 7
AUTHORS' CONCLUSIONS........................................................................................................................................................................... 7
ACKNOWLEDGEMENTS................................................................................................................................................................................ 8
REFERENCES................................................................................................................................................................................................ 9
CHARACTERISTICS OF STUDIES.................................................................................................................................................................. 10
APPENDICES................................................................................................................................................................................................. 10
HISTORY........................................................................................................................................................................................................ 22
CONTRIBUTIONS OF AUTHORS................................................................................................................................................................... 22
DECLARATIONS OF INTEREST..................................................................................................................................................................... 23
SOURCES OF SUPPORT............................................................................................................................................................................... 23
DIFFERENCES BETWEEN PROTOCOL AND REVIEW.................................................................................................................................... 23
Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) i

Informed decisions.
[Intervention Review]
Topical mydriatics as adjunctive therapy for traumatic iridocyclitis
Jeffrey Hom1, Salman Sarwar2, Mona A Kaleem3, Catherine R Messina4, Samuel A Abariga5, Quan Dong Nguyen6
1Departments of Pediatrics and Emergency Medicine, Stony Brook University Renaissance School of Medicine, Stony Brook, New
York, USA. 2Department of Ophthalmology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. 3Ophthalmology, Wilmer Eye
Institute, Johns Hopkins University, Bethesda, Maryland, USA. 4Department of Family, Population, and Preventive Medicine, Stony
Brook University, Renaissance School of Medicine, Stony Brook, New York, USA. 5Department of Ophthalmology, University of Colorado
Anschutz Medical Campus, Denver, Colorado, USA. 6Byers Eye Institute, Stanford University, Palo Alto, California, USA
Contact address: Jeffrey Hom, [email protected], [email protected].
Editorial group: Cochrane Eyes and Vision Group.

Publication status and date: New, published in Issue 8, 2020.
Citation: Hom J, Sarwar S, Kaleem MA, Messina CR, Abariga SA, Nguyen QD. Topical mydriatics as adjunctive therapy for traumatic
iridocyclitis. Cochrane Database of Systematic Reviews 2020, Issue 8. Art. No.: CD013260. DOI: 10.1002/14651858.CD013260.pub2.
ABSTRACT
Background
Traumatic eye complaints account for 3% of all hospital emergency department visits. The most common traumatic injury to the eye is
blunt trauma, which accounts for 30% of these visits. Blunt trauma frequently leads to traumatic iridocyclitis, thus causing anterior uveitis.
Iridocyclitis frequently causes tearing, photophobia, eye pain, and vision loss. These symptoms are a result of the inflammatory processes
and ciliary spasms to iris muscles and sphincter. The inflammatory process is usually managed with topical corticosteroids, while the ciliary
spasm is blunted by dilating the pupils with topical mydriatic agents, an adjuvant therapy. However, the effectiveness of mydriatic agents
has not been quantified in terms of reduction of ocular pain and visual acuity loss.
Objectives
To evaluate the effectiveness and safety of topical mydriatics as adjunctive therapy to topical corticosteroids for traumatic iridocyclitis.
Search methods
We searched the Cochrane Central Register of Controlled Trials (CENTRAL) which contains the Cochrane Eyes and Vision Trials
Register (2019, issue 6); Ovid MEDLINE; Embase.com; Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus; PubMed;
ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date
or language restrictions in the electronic search for trials. We last searched the electronic databases on 12 June 2019.
Selection criteria
We planned to include randomized controlled trials (RCTs) that compared topical mydriatic agents in conjunction with topical
corticosteroid therapy versus topical corticosteroids alone, in participants with traumatic iridocyclitis.
Data collection and analysis

Two review authors (JH, MK) independently screened titles and abstracts, then full-text reports, against eligibility criteria. We planned to
have two authors independently extract data from included studies. We resolved differences in opinion by discussion.
Main results
There were no eligible RCTs that compared the interventions of interest in people with traumatic iridocyclitis.
Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 1

Informed decisions.
Authors' conclusions
We did not find any evidence from RCTs about the efficacy of topical mydriatic agents as an adjunctive therapy with topical corticosteroids
for treating traumatic iridocyclitis. In the absence of these types of studies, we cannot draw any firm conclusions. Controlled trials that
compare the combined use of topical mydriatic agents and corticosteroid drops against standard corticosteroid drops alone, in people
with traumatic iridocyclitis are required. These may provide evidence about the efficacy and risk of topical mydriatic drops as adjuvant
therapy for traumatic iridocyclitis.
PLAIN LANGUAGE SUMMARY
What are the benefits and risks of eye drops that widen the pupil as an additional treatment for inflammation after a blow to the
eye?
Why this question is important

Hospital emergency departments often treat people with eye injuries. There are two main types of eye injuries:
• blunt trauma injuries, when an object or force strikes the eye. Common causes of blunt trauma to the eye include motor vehicle accidents,
sports- or work-related accidents, or fights;
• penetrating trauma injuries, when a sharp object or an object traveling at high speed (for example, from pellets fired by air-powered
guns) pierces the eye.
Blunt trauma is the more common form of eye injury. People who have these injuries often develop traumatic iridocyclitis, an inflammation
of the iris (the colored part of the eye that surrounds the black pupil) and the ciliary body (the muscles and tissue around the iris). Traumatic
iridocyclitis can develop after both major and minor blunt trauma, and can affect children as well as adults. Symptoms associated with
damage to the iris and ciliary body include eye pain and sensitivity to light. If the inflammation goes unnoticed or is not treated properly,
it can cause vision loss.
The standard treatment for traumatic iridocyclitis is anti-inflammatory eye drops (corticosteroids). Eye drops that widen the pupil
(mydriatics) are usually used as an additional treatment, to reduce eye pain and discomfort, and to shorten the duration of symptoms.
We aimed to find out whether the use of mydriatics plus corticosteroids to treat traumatic iridocyclitis is beneficial or causes more
unwanted effects than corticosteroids alone by reviewing the research evidence. Specifically, we wanted to know if mydriatics relieve eye
pain and inflammation and improve vision. We also wanted to find out if mydriatics cause complications such as chronic pain, and if they
have any serious negative effects on sight (including blindness).
How we searched for evidence

Our team of researchers searched the medical literature for:
• randomized controlled trials: these are medical studies where people are randomly put into one of two or more treatment groups. This
type of study provides the most reliable evidence about whether a treatment makes a difference;
• studies on people of all ages with traumatic iridocyclitis;
• studies that compared the effects of mydriatics plus corticosteroids against corticosteroids alone.
What we found
We found no randomized controlled trials to help us answer our question. Therefore, we do not know whether the addition of mydriatics
to corticosteroids is beneficial or causes more unwanted effects than corticosteroids alone in the treatment of traumatic iridocyclitis. We
need researchers to conduct future studies that compare mydriatics plus corticosteroids against corticosteroids, so that we can assess the
benefits and risks of mydriatics as an additional treatment for traumatic iridocyclitis.
How up-to-date is this review?

We last searched for evidence on 12 June 2019. This review covered research that was available up to that date, but did not consider any
evidence that may have been produced since then.

Informed decisions.
BACKGROUND Presentation and diagnosis

The pathophysiology of traumatic iridocyclitis involves the
Description of the condition
unmasking or worsening of an underlying inflammatory process
Ocular trauma arising from a systemic or infectious cause (Sepah 2013). As
the anterior chamber fills with white blood cells and pigmented
Hospital emergency department visits for eye-related complaints
cells, individuals describe a dull or aching eye pain, photophobia,
are common. Eye trauma accounts for 3% of all emergency
diminished vision, and tearing within three days of the eye injury
department visits in the USA (Romaniuk 2013), with an estimated
(Logothetis 2014). Traumatic iridocyclitis presents as a red eye,
average of 2.4 million visits for ocular complaints each year (Brandt
characterized by ciliary flush, cells, and flare in the anterior
2001; Haring 2016). The admission rate for eye injuries has been
chamber, and poorly dilated pupils (miosis). Other findings include
estimated as 3.1% of emergency department visits, compared
alterations in intraocular pressure (IOP), mydriasis (dilation of the
with 8.1% for all other types of trauma (Owens 2011). The typical
pupil), conjunctival injection surrounding the limbus, decreased
individual experiencing ocular trauma is a 20-year-old man (Haring
vision, and floaters.
2016; May 2000).
The symptoms and physical findings are a result of ciliary spasms,
The types and patterns of ocular injury present differently,
which cause inflammation of the iris dilator muscle and the iris
depending on whether the trauma is blunt or penetrating. The
sphincter. Inflammation of the iris can cause the iris to tear, cut,
most common mechanisms of ocular injury are blunt trauma (30%)
and bruise, and can increase IOP. Damage to the ciliary body can
and sharp objects (18%); in terms of specific events, motor vehicle
lead to accumulation of debris in the trabecular meshwork (Dunn
collisions account for 9% of ocular injuries and gunshot wounds
2015). Cataracts, glaucoma, and retinal detachment are possible
account for 6% (May 2000). Most ocular injuries occur in the home
complications of traumatic iridocyclitis.
(41%), whereas 14% occur in the industrial setting (May 2000).
Eye injuries can lead to significant changes in an individual's life, in

Description of the intervention
terms of morbidity and quality of life. Although eyes represent only The standard therapy for traumatic iridocyclitis, the application
0.3% of a person's total body surface area, the loss of one eye leads of topical corticosteroids, acts by reducing the cyclo-oxygenase
to approximately 24% of whole-person impairment (i.e. significant inflammatory response (inflammation associated with increased
malfunction or loss of use), whereas the loss of both eyes leads to blood flow). Mydriatic agents are usually applied topically to
85% disability (Brandt 2001). make the pupil dilate by one of two mechanisms: either by
temporarily paralyzing the iris sphincter muscles (parasympathetic
Traumatic iridocyclitis antagonists) or stimulating the iris dilator muscle (sympathetic
One consequence of ocular trauma is traumatic iridocyclitis agonists). Parasympathetic antagonists (e.g. tropicamide) tend to
(inflammation of the iris), which is associated with significant have a longer duration of action than sympathetic agonists (e.g.
morbidity and vision loss when not recognized and managed phenylephrine).
properly. Iridocyclitis can develop even after minor non-
penetrating ocular trauma. Reported rates of traumatic iridocyclitis How the intervention might work
range from 0.4% to 49% (Macewen 1989; Oner 2006). Differences in The adjuvant use of topical mydriatic agents, also administered
time periods, geographic locations (London 2010), and surveillance topically, may help to stabilize blood flow and mitigate ciliary
methodology and countries' income level account for the spasm by paralyzing the iris and ciliary body. In addition, mydriatic
variability in reported rates (London 2010; Macewen 1989; Oner agents may prevent iris-lens adhesions (i.e. posterior synechiae)
2006; Soliman 2008). by keeping the iris dilated and minimizing contact between them.
The net effect is to reduce pain and discomfort, and shorten the
Traumatic iridocyclitis is one of the most common types of anterior
duration of ciliary spasms.
uveitis (inflammation of the uvea — the middle layer of the eyeball
consisting of the iris, ciliary body and choroid). Engelhard 2015a Why it is important to do this review
reported that 12.2% of all uveitis cases were attributed to trauma
during a 30-year surveillance period. There is clinical uncertainty about the benefits and harms of
adjunctive topical mydriatics. Given that significant ocular pain and
Children are an important subgroup of individuals who suffer diminished visual acuity can occur with traumatic iridocyclitis, it
ocular trauma, and they experience greater morbidity from is important to evaluate the role of adjunctive topical mydriatics
traumatic iridocyclitis. Children represent a diagnostic challenge in the management of this condition. No Cochrane Review on
because of their inability to communicate their symptoms and to this topic exits and the only systematic review on this topic
comply with the required physical examination (Engelhard 2015a). published ten years ago found no eligible randomized controlled
Traumatic iridocyclitis is one of the most common identifiable trials (RCTs)e.
reasons for uveitis in this age group, along with juvenile idiopathic
arthritis (JIA) and undifferentiated causes (Engelhard 2015b). OBJECTIVES
Traumatic iridocyclitis represents about 25% of all pediatric non-
JIA uveitis (Engelhard 2015b), with a prevalence of 9.1% (BenEzra To evaluate the effectiveness and safety of topical mydriatics
2005). as adjunctive therapy to topical corticosteroids for traumatic
iridocyclitis.

Informed decisions.
METHODS If mean change from baseline data were not available for BCVA
or IOP outcomes, we planned to calculate the mean difference in
Criteria for considering studies for this review measurements taken at each time point to estimate between-group
effects.
Types of studies
We planned to include randomized controlled trials (RCTs). We Adverse events
excluded cross-over trials, within-person trials, and n-of-1 trials We planned to compare the proportion of participants with serious
(single person clinical trials). ocular adverse events, such as blindness and chronic pain, and
systemic adverse events between the two groups at one week,
Types of participants
two weeks, and one month after treatment. We planned to include
We planned to include trials that enrolled participants of any both spontaneously reported and systematically collected adverse
age with traumatic iridocyclitis. We excluded trials that enrolled events.
participants with open globe injuries or injuries that involved
the posterior segments of the eye, because these injuries require Search methods for identification of studies
surgical intervention. Electronic searches
Types of interventions The Cochrane Eyes and Vision (CEV) Information Specialist
searched the following electronic databases for RCTs and
The primary intervention group in eligible trials would have
controlled clinical trials. There were no restrictions to language or
received topical mydriatic agents in conjunction with topical
year of publication. We last searched the electronic databases on
corticosteroids. The comparison group would have been treated
12 June 2019.
with topical corticosteroids alone, regardless of dose, frequency,
or length of administration. We excluded placebo-controlled trials, • Cochrane Central Register of Controlled Trials (CENTRAL; 2019,
with the planned exception of multi-armed trials which reported Issue 6, which contains the Cochrane Eyes and Vision Trials
outcomes separately for the two targeted interventions. Register) in the Cochrane Library (searched 12 June 2019)
(Appendix 1).
Types of outcome measures
• MEDLINE Ovid (1946 to 12 June 2019) (Appendix 2).
Primary outcomes
• Embase.com (1947 to 12 June 2019) (Appendix 3).
• Proportion of participants with resolution of signs and • CINAHL Plus (Cumulative Index to Nursing and Allied Health
symptoms at one week after treatment, as defined by trial Literature; January 1937 to 12 June 2019) (Appendix 4).
investigators. Typical definitions of resolution include absence • PubMed (1948 to 12 June 2019) (Appendix 5).
of signs (anterior chamber cells, ciliary flushing) and symptoms
• US National Institutes of Health Ongoing Trials Register
(ocular pain, floaters).
ClinicalTrials.gov (www.clinicaltrials.gov; searched 12 June
Secondary outcomes 2019) (Appendix 6).
• World Health Organization (WHO) International Clinical Trials
• Proportion of participants with resolution of signs and Registry Platform (ICTRP) (www.who.int/ictrp; searched 12 June
symptoms at two weeks and one month after treatment, as 2019) (Appendix 7).
defined by trial investigators.
• Proportion of participants with ocular pain at one week, two Searching other resources
weeks, and one month after treatment, as defined by trial
We searched the reference lists of review articles, relevant trials,
investigators.
and textbooks to identify additional trials. We did not impose any
• Proportion of participants with evidence of ocular inflammation language or date restrictions.
(such as cells in the anterior chamber, ciliary flushing, and
floaters) at one week, two weeks, and one month after Data collection and analysis
treatment, as defined by trial investigators.
Selection of studies
• Proportion of participants with synechiae at one week, two
weeks, and one month after treatment, as defined by trial Two review authors (JH and MK) independently screened the titles
investigators. and abstracts of all records and assessed the relevance of each.
• Mean change in best-corrected visual acuity (BCVA) from We obtained full-text copies of reports from potentially relevant
baseline to one week, two weeks, and one month after studies. Two review authors (JH and MK) independently assessed
treatment, as defined by trial investigators. When possible, we the full-text reports to determine the final eligibility of studies.
considered using Logarithm of the Minimum Angle of Resolution At all stages, we resolved any discrepancies by discussion or by
(logMAR) visual acuity values, with Early Treatment Diabetic consulting a third review author (SS) whenever necessary. We
Retinopathy Study (ETDRS) letters or logMAR acuity of 0.1 be a listed the excluded studies and their reasons for exclusion in the
clinically meaningful difference. ‘Characteristics of excluded studies' table. We illustrated the study
• Mean change in IOP from baseline to one week, two weeks, and selection process in a PRISMA diagram (Figure 1).
one month after treatment, as defined by trial investigators. We
considered 2 mmHg to be a clinically meaningful difference.

Informed decisions.
Figure 1. Study flow diagram.

Informed decisions.
Data extraction and management Unit of analysis issues

We planned to have two review authors (JH and YS) independently The ideal unit of analysis was to have been the individual, such as
extract data from each eligible study using forms developed and when trial participants had only one eye affected, or when the trial
piloted by CEV. We planned to extract and enter the following treated both affected eyes in the same way and analyzed them as
information into a systematic review data repository (see also a unit. For any studies that used a within-person design, in which
Appendix 8). they randomized both participants' (affected) eyes separately, we
had planned to use estimates that accounted for the paired design
• Study characteristics: country, setting, publication year, status in the analysis. For eligible multi-arm trials, we planned to provide
of publication, title, authors, source, language of publication, study characteristics for all groups and include only relevant groups
and funding sources. for analysis, without double-counting participants.
• Methods: study duration, randomization technique, allocation
concealment method, masking (participants, provider, outcome Dealing with missing data
assessors), analysis (intention-to-treat versus per protocol or We had planned to contact the trial authors to obtain supplemental
other). information on missing data. This was to be done via email, and if
• Participants: source, sampling (random or convenience), no response had been received within two weeks of the request, we
number in comparison groups, age, gender, similarity of groups had planned to use the information available in the study reports.
at baseline, withdrawals/losses to follow-up (reasons), and We did not plan to impute data for the purposes of this review;
subgroups for which outcomes were reported. however, if the trial investigators had reported imputed outcome
• Interventions: description of adjuvant mydriatics used plus data, we would have used this. We would then have performed a
topical corticosteroids and topical corticosteroids alone (dose sensitivity analysis, in which we would have excluded studies with
and duration). high attrition rates (greater than 20%).
• Outcomes: primary and secondary outcomes, times of
Assessment of heterogeneity
assessment, and length of participant follow-up (planned and
actual). We planned to assess clinical and methodological heterogeneity
among included trials to determine whether meta-analysis was
If we had found outcome data that were shown only in figures (e.g. appropriate. If we observed substantial clinical or methodological
means and standard deviations), we had planned to use GetData heterogeneity, we had planned to present a narrative summary of
Graph Digitizer 2.24 (getdata-graph-digitizer.com) to estimate data the trial results. When trials were clinically and methodologically
values from the figures. We would have requested confirmation homogeneous, we would have combined data using meta-analysis
from study investigators. If they had not replied within two weeks, and evaluated statistical heterogeneity using a Chi2 test (with
we had planned to use the data values we had estimated.
a 10% level of statistical significance), the I2 statistic (with
Assessment of risk of bias in included studies ≥ 50% representing substantial statistical heterogeneity), and
examination of forest plots for overlapping CIs (McKenzie 2019).
We planned that two review authors (JH and MK) would
independently assess the risk of bias for each included trial, Assessment of reporting biases
according to Chapter 8 of the Cochrane Handbook for Systematic
We had planned to assess small study effects using funnel plots
Reviews of Interventions (Higgins 2019). We would have assessed
when 10 or more trials were included in a meta-analysis. We
risk of bias using domain-based evaluations regarding selection
would have considered that an asymmetrical funnel plot may have
bias (random sequence generation, allocation concealment before
been the result of reporting bias, heterogeneity, and differences
randomization), performance bias (masking of participants and
in the methodological quality of studies. We would have assessed
study personnel), detection bias (masking of outcome assessors),
selective outcome reporting as part of our assessment of the risk of
attrition bias (amount and appropriate handling of missing data),
bias in the included studies.
reporting bias (lack of selective outcome reporting), and 'other'
potential sources of bias. We would have judged each trial for each Data synthesis
‘Risk of bias' domain as ‘low risk', ‘high risk', or ‘unclear risk'.
We had planned to conduct meta-analyses using Review Manager 5
Measures of treatment effect (Review Manager 2014), using a random-effects model unless there
were fewer than three trials, in which case we would have used the
We planned to analyze dichotomous outcomes as risk ratios with
fixed-effect model.
95% confidence intervals (CIs). Dichotomous outcomes for this
review included the proportion of participants with resolution of Subgroup analysis and investigation of heterogeneity
signs and symptoms, the proportion of participants with ocular
pain, the proportion of participants with evidence of ocular Whenever sufficient data were reported, we had planned to
inflammation, the proportion of participants with synechiae, and perform subgroup analyses according to the following participant
the proportion of participants with serious ocular or systemic and treatment characteristics: age (less than 18 years, 18 years or
adverse events. older), and level and type of injury (e.g. Glasgow coma scale, other
trauma severity score, blunt injury). We planned to investigate
We would have analyzed continuous outcomes as mean differences differences between subgroups using tests for interaction (with P <
with 95% CIs. Continuous outcomes for this review included mean 0.1 to indicate a treatment-characteristic interaction). We had also
change in BCVA and IOP. planned to report any post hoc subgroup analyses, and the number
of analyses that we had performed.

Informed decisions.
Sensitivity analysis 1979 did not include our population of interest, and the remaining
two studies were not RCTs (Islam 2010; Melton 1991).
The plan was to use sensitivity analyses to examine the impact
of excluding studies at high risk of selection, detection, and Risk of bias in included studies
attrition biases, studies that had provided only unpublished data,
and industry-funded studies. However, we did not undertake this We did not identify any eligible studies, so could not assess their
because we did not identify any eligible studies for inclusion in the risk of bias in this review.
review.
Effects of interventions
‘Summary of findings' table
We did not identify any eligible studies, so could not assess the
The plan was to construct a ‘Summary of findings' table that effects of the intervention in this review.
included effect estimates for the following primary outcome and
key secondary outcomes. DISCUSSION
• Proportion of participants with resolution of signs and Summary of main results

symptoms at one week after treatment, as defined by trial
Our literature search did not find any randomized controlled trial
investigators.
(RCTs) that met the inclusion criteria for this review. We found
• Proportion of participants with ocular pain at one week after one empty review article on this topic (see Agreements and
treatment, as defined by trial investigators. disagreements with other studies or reviews).
• Proportion of participants with evidence of ocular inflammation
(such as cells in the anterior chamber, ciliary flushing, and Overall completeness and applicability of evidence
floaters) at one week after treatment, as defined by trial
investigators. The benefits and harms of the use of adjunctive topical mydriatics
still remain uncertain. Although we performed a robust literature
• Proportion of participants with synechiae at one week after search of seven electronic medical databases, aided by an
treatment, as defined by trial investigators. Information Specialist, we found no studies that met the inclusion
• Mean change in BCVA from baseline to one week after treatment, criteria. These findings highlight the need for RCT evidence. Given
as defined by trial investigators. the lack of evidence, there is no basis upon which we can draw
• Mean change in IOP from baseline to one week after treatment, conclusions about the applicability of evidence.
as defined by trial investigators.
• Proportion of participants with serious ocular adverse events at Quality of the evidence
one week after treatment. We did not find any eligible studies for this review, hence the quality
of evidence remains uncertain.
We had also planned to use the GRADE approach and its five major
domains (risk of bias, inconsistency, directness, imprecision, and Potential biases in the review process
publication bias) to grade the certainty of evidence (very low, low,
medium, high) for each outcome included in the ‘Summary of In order to minimize any potential biases that may have
findings' table (Schünemann 2011). arisen during the review process, we followed the Cochrane
Handbook for Systematic Reviews of Interventions (Higgins 2011),
RESULTS and the Methodological Expectations of Cochrane Intervention
Reviews (MECIR) Standards for the reporting of new Cochrane
Description of studies Intervention Reviews (editorial-unit.cochrane.org/mecir). A trained
We did not find any eligible studies for this review. Cochrane Eyes and Vision Information Specialist performed a
highly comprehensive search for trials for this review, without
Results of the search publication date or language limitations. Two review authors
independently screened titles, abstracts and full text. We did not
The electronic search conducted on 12 June 2019 identified a include non-randomized studies, due to their potential risk for bias.
total of 724 records (Figure 1). After removing 106 duplicates, we
screened the remaining 618 records. We excluded 615 records Agreements and disagreements with other studies or
that did not meet eligibility criteria after screening their titles and reviews
abstracts. We obtained three potentially eligible full-text records
for further evaluation. We excluded all three full-text records with In agreement with our review, the authors of another systematic
reasons after full-text review, on the basis of their study design or review were unable to comment on the effectiveness of mydriatic
the type of participants included. agents for traumatic iridocyclitis as they found no eligible RCTs
(Islam 2010).
Included studies
AUTHORS' CONCLUSIONS
We did not identify eligible studies for inclusion in this review.
Implications for practice
Excluded studies
There is no evidence available from RCTs to support the use of
We excluded three studies and documented their reasons for
mydriatic drops as an adjuvant therapy for traumatic iridocyclitis.
exclusion in the Characteristics of excluded studies table. Dunne
Consequently, there is no basis for recommendations to either

Informed decisions.
support or oppose the use of mydriatic drops as an adjuvant this condition. Data on adverse outcomes, including serious ocular
therapy for traumatic iridocyclitis. adverse events (such as elevated intraocular pressure, lens opacity,
blindness, chronic pain), and systemic adverse events at one week,
Implications for research two weeks and one month after treatment initiation should also be
collected.
It is evident from this review that well-designed RCTs are needed
to evaluate the benefits and risks of mydriatic agents as adjuvant
ACKNOWLEDGEMENTS
therapy for traumatic iridocyclitis. We recommend that future
trials should evaluate standard therapy with topical corticosteroids We acknowledge Lori Rosman, CEV Information Specialist, for
compared with therapy that includes mydriatic agents along creating and executing the electronic search strategies. We thank
with topical corticosteroids. Such trials should also assess other Yasir J Sepah for his contributions to the published protocol of this
factors, such as time to initiation of therapy, co-injuries (ocular review (Hom 2019). We thank Henry Jampel (Wilmer Eye Institute)
and non-ocular) as well as other underlying medical conditions. and the one peer reviewer who wishes to remain anonymous for
Since traumatic iridocyclitis often causes pain and may lead to providing comments.
diminished visual acuity or blindness, future trials should also
consider evaluating visual acuity and other short-term (one week) This review update was managed by CEV@US and was signed off
or long-term (two weeks to one month) clinical measures of vision, for publication by Tianjing Li and Richard Wormald.
quality of life and outcomes that are important to people with

Informed decisions.
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Brandt MT, Haug RH. Traumatic hyphema: a comprehensive
review. Journal of Oral and Maxillofacial Surgery McKenzie 2019
2001;59(12):1462-70.
McKenzie JE, Brennan SE, Ryan RE, Thomson HJ, Johnston RV.
Dunn 2015 Chapter 9: Summarizing study characteristics and preparing for
synthesis. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li
Dunn JP. Uveitis. Primary Care 2015;42(3):305-23.
T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic
Engelhard 2015a Reviews of Interventions version 6.0 (updated July 2019).
Cochrane, 2019. Available from www.training.cochrane.org/
Engelhard SB, Patrie J, Prenshaw J, Bajwa A, Monahan R,
handbook.
Reddy AK. Traumatic uveitis in the mid-Atlantic United States.
Clinical Ophthalmology 2015;9:1869-74. Oner 2006
Engelhard 2015b Oner A, Kekec Z, Krakucuk S, Ikizceli I, Sözüer EM. Ocular trauma
in Turkey: a 2-year prospective study. Advances in Therapy
Engelhard SB, Bajwa A, Reddy AK. Causes of uveitis in children
2006;23(2):274-83.
without juvenile idiopathic arthritis. Clinical Ophthalmology
2015;9:1121-8. Owens 2011
Glanville 2006 Owens PL, Mutter R. Emergency department visits related
to eye injuries, 2008: Statistical Brief #112. Healthcare Cost
Glanville JM, Lefebvre C, Miles J NV, Camosso-Stefinovic J. How
and Utilization Project (HCUP) Statistical Briefs. Rockville
to identify randomized controlled trials in MEDLINE: ten years
(MD): Agency for Healthcare Research and Quality (US); 2011.
on. Journal of the Medical Library Association 2006;94(2):130-6.
available at; www.ncbi.nlm.nih.gov/books/NBK56035/.
Haring 2016
Review Manager 2014 [Computer program]
Haring RS, Canner JK, Haider AH, Schneider EB. Ocular injury
Nordic Cochrane Centre, The Cochrane Collaboration Review
in the United States: emergency department visits from
Manager 5 (RevMan 5). Version 5.3. Copenhagen: Nordic
2006-2011. Injury 2016;47(1):104-8.
Cochrane Centre, The Cochrane Collaboration, 2014.
Higgins 2011
Romaniuk 2013
Higgins JP, Green S, editor(s). Cochrane Handbook for
Romaniuk VM. Ocular trauma and other catastrophes.
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Emergency Medicine Clinics of North America 2013;31(2):399-411.
March 2011). The Cochrane Collaboration, 2011. Available from
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8: Assessing risk of bias in a randomized trial. In: Higgins
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Sepah 2013 Hom 2019
Sepah YJ, Akhtar A, Shulman M, Nguyen QD. Traumatic uveitis. Hom Jeffrey, Sarwar Salman, Kaleem Mona A, Messina
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Uveitis. 2nd edition. New Delhi (India): Jaypee Borhters Medical mydriatics as adjunctive therapy for traumatic iridocyclitis and
Publishers, 2013:1266-83. iritis. Cochrane Database of Systematic Reviews 2019, Issue 3.
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2008;246(2):205-12.
CHARACTERISTICS OF STUDIES
Characteristics of excluded studies [ordered by study ID]
Study Reason for exclusion
Dunne 1979 Not the population of interest
Islam 2010 Not an RCT
Melton 1991 Not an RCT
RCT = randomized controlled trial
APPENDICES
Appendix 1. CENTRAL search strategy

#1 MeSH descriptor: [Uveitis] explode all trees
#2 Iridocycliti*
#3 iritis* or iritide*
#4 Cycliti*
#5 scleriti*
#6 uveiti*
#7 (sclera or iris or ciliary) and (inflam*)
#8 {or #1-#7}
#9 MeSH descriptor: [Mydriatics] explode all trees
#10 mydriatic*
#11 cycloplegic*
#12 MeSH descriptor: [Atropine] explode all trees
#13 Atropine or atrinal or "atro-polygyl" or atrop or atropen or atropin or atropina or "atropini sulfas" or atropinol or atropisol or atropt or
atroptol or atrospan or "atrosulf-1" or "bar bropin" or "bellpino-artin" or "cendo tropine" or "dextro levo hyosciamine" or "ichtho bellol"
or "isopto" or isoptoAtropine or "ocu-tropine" or "sal-tropine" or skiatropine or "tropine dextro levo tropate" or ximex or "51-55-8" or
"55-48-1"
#14 berefrine or POPD or "105567-83-7"
#15 MeSH descriptor: [Cyclopentolate] explode all trees
#16 Cyclopentolate or "ak-pentolate" or akpentolate or "bell pentolate" or ciclolux or cyclogyl or cyclomydri or cyclopentol or
cyclopentolat or cylate or cyplegin or diopentolate or midriodavi or mydrilate or "ocu-pentolate" or ocucyclo or "oftan-syklo" or pentolair
or "refractyl ofeno" or skiacol or zyklolat or "512-15-2" or "5870-29-1"
#17 MeSH descriptor: [Epinephrine] explode all trees
#18 Epinephrine or Adrenaline or adrenalin or Epitrate or Lyophrin or Epifrin or adnephrin or adnephrine or "adrenal hydrochloride" or
adrenalina or adrenamine or adrenapax or adrenazin or adrenine or adrin or adrine or advaradin or balmadren or biorenine or bosmin or
chelafrin or dylephrin or epiglaufrin or epimephrine or epinefrina or epinephran or epinephrin or epirenamine or epirenan or exadrin or
glaucon or glaucosan or glaufrin or "glin epin" or glycirenan or haemostatin or hemisine or hemostasin or hemostatin or hypernephrin
Informed decisions.
or "isopto epinal" or levoadrenalin or levoadrenaline or levoepinephrine or levorenin or levorenine or methylaminoethanolcatechol

or methylarterenol or mucidrina or myosthenine or "n methylnoradrenalin" or nephridine or nieraline or paranephrin or posumin or
renaglandin or renaglandulin or renaleptine or renalina or renaline or renoform or renostypticin or renostyptin or scurenaline or simplene
or soladren or sphygmogenin or styptirenal or supracapsulin or supranephrane or supranephrin or supranol or suprarenaline or suprarenin
or suprarenine or suprel or surenine or surrenine or "sus-phrine sulfite-free" or susphrine or "sympathin I" or takamina or tonogen or
vasoconstrictine or vasodrine or vasotonin or weradren or "51-43-4" or "55-31-2" or "6912-68-1"
#19 MeSH descriptor: [Ethylmorphine] explode all trees
#20 Ethylmorphine or Ethomorphine or Trachyl or codethyline or diolan or dionine or "ethyl morphine" or ethylmorfine or ethylmorphin
or "morphine ethyl ether" or "125-30-4" or "76-58-4"
#21 Eucatropine or euphthalmine or "100-91-4" or "536-93-6"
#22 Homatropine or homatro or homatrocil or homatropaire or homatropin or homatropina or isoptoHomatropine or "I Homatrine" or
"mandelyl tropeine" or mandelyltropeine or "mydryn eye" or "omatropina lux" or "tropine mandelate" or "51-56-9" or "87-00-3"
#23 MeSH descriptor: [Hyoscyamine] explode all trees
#24 Hyoscyamine or anaspaz or cystospaz or cytospaz or daturine or donnamar or duboisine or egacen or hyoscamine or hyosciamine or
hyoscyanin or hyosyne or "ib-stat" or levbid or levsin or "levsinex sr" or neosol or nulev or spasdel or "symax sl" or "symax sr" or "tropine
l tropate" or "101-31-5" or "306-03-6"
#25 Ibopamine or "N-methyldopamine diisobutyrate" or "SB 7505" or "SB7505" or Escandine or Inopamil or "diisobutyric n
methyldopamine ester" or scandine or "skf 100168" or "skf 100168 a" or "66195-31-1" or "75011-65-3"
#26 Methylatropine or "8-methylatropinium nitrate" or "31610-87-4"
#27 MeSH descriptor: [Naphazoline] explode all trees
#28 Naphazoline or "Afazol Grin" or "AK Con" or AKCon or Albalon or albasol or "All Clear" or allersol or antan or benil or cefasan or "Clear
Eyes" or coldan or "Colirio Alfa" or "comfort eye drops" or dazolin or "degest 2" or derinox or Idril or imidin or minha or Miraclar or mirafrin
or Nafazair or nafazoline or naftazolina or "naphacel ofteno" or naphasal or naphazolin or Naphcon or "naphozoline hydrochloride" or
naphtears or naphthazoline or naphthizine or naphthyzin or nastizol or "nazil ofteno" or niazol or "ocu-zoline" or opcon or Optazine or
Privin or privina or Privine or privine or Proculin or rhinantin or rhinazin or rhinoperd or rimidol or sanorin or sanotin or Siozwo or strictylon
or "Tele Stulln" or TeleStulln or Vasoclear or Vasocon or "Vasoconstrictor Pensa" or VasoNit or vistalbalon or vistobalon or "5144-52-5" or
"550-99-2" or "835-31-4"
#29 Oxedrine or Synephrine or Sympaethamin or Synephrin or aetaphen or pentedrine or vasoton or "94-07-5"
#30 MeSH descriptor: [Synephrine] explode all trees
#31 MeSH descriptor: [Oxyphenonium] explode all trees
#32 Oxyphenonium or Methacin or Oxyphenon or Atrenyl or Spastrex or antrenyl or "ba 5473" or ba5473 or "c 5473" or c5473 or helkamon
or metacin or metacinum or oxyphenium or "oxyphenomium bromide" or spasmofen or spasmophen or "14214-84-7" or "50-10-2"
#33 MeSH descriptor: [Phenylephrine] explode all trees
#34 Phenylephrine or adrianol or "af-taf" or "ak-dilate" or "albalon relief" or alconefrin or almefrin or altafrin or biomidrin or biomydrin
or derizene or "despec-sf" or drosin or "efrin-10" or efrisel or fenylephrine or idrianol or isonefrine or isophrin or isophrine or "isopto
frin" or isoptofrin or lexatol or "m synephrine" or mesaton or "meta sympathol" or "meta synephrine" or Metaoxedrin or metaoxedrine or
Metasympatol or metasynephrine or Mezaton or "murucoll 2" or mydfrin or "n 105 to" or "nefrin-ofteno" or "Neo Synephrine" or neofrin
or neooxedrine or neophryn or neosynephrin or Neosynephrine or "neosynephrin-pos" or neosynesin or neosynesine or "ocu-phrin" or
"oftan-metaoksedrin" or optistin or phenoptic or phenylefrine or phenylephedrine or prefrin or "pupiletto forte" or rectasol or "rhinall 10"
or "slv 325" or slv325 or sucraphen or vazculep or visadron or vistafrin or vistosan or "532-38-7" or "59-42-7" or "61-76-7"
#35 Pholedrine or "4 hydroxy n methylamphetamine" or "4 hydroxymethamphetamine" or adyston or "para hydroxymethamphetamine"
or "p-hydroxymethamphetamine" or paredrinol or "Pholedrin liquidum" or "Pholedrin-longo-Isis" or pulsotyl or venosan or veritol or
"370-14-9"
#36 MeSH descriptor: [p-Hydroxyamphetamine] explode all trees
#37 p-Hydroxyamphetamine or "1 para hydroxyphenyl 2 propylamine" or "alpha methyl para tyramine" or "alpha methyl tyramine" or
"dl 1 p hydroxyphenyl 2 propylamine" or "dl 1 para hydroxyphenyl 2 propylamine" or "dl p hydroxy alpha methylphenethylamine" or
"dl para hydroxy alpha methylphenethylamine" or "h 66 37" or "para hydroxy alpha methylphenethylamine" or Hydroxyamfetamine or
Hydroxyamphetamin or Hydroxyamphetamine or Hydroxyphenylisopropylamine or Methyltyramine or Norpholedrin or norpholedrine or
oxamphetamine or Oxyamphetamine or paradrine or parahydroxyamphetamine or Paredrine or paredrinea or paredrinex or pedrolone or
pulsoton or "103-86-6" or "1518-86-1" or "306-21-8"
#38 MeSH descriptor: [Racepinephrine] explode all trees
#39 Racepinephrine or Micronefrin or micronefrine or Micronephrine or mikronephrin or racadrenalin or "Racepinefrine Hydrochloride"
or racinephrine or Vaponefrin or vaponefrine or vaponephrin or "329-65-7"
#40 MeSH descriptor: [Scopolamine Hydrobromide] explode all trees
#41 Scopolamine or "Boro Scopol" or BoroScopol or Hyoscine or Kwells or "levo hyoscinehydrobromide" or Scoburen or Scopace or scopos
or "Travacalm HO" or Vorigeno or "114-49-8" or atrochin or atroquin or atroscine or hyosceine or hyscoor "l epoxytropine tropate" or "n
methylhyoscine" or oscine or scopalamine or "scopine tropate" or scopolamin or transcop or "tropic acid ester with scopine" or "138-12-5"
or "51-34-3" or "55-16-3"
#42 MeSH descriptor: [Tropicamide] explode all trees
#43 Tropicamide or "alcon-mydril" or bistropamide or "cendo mydriatyl" or "Colircusi Tropicamida" or midriaticum or mydiacyl or
mydral or mydramide or mydriacyl or Mydriafair or Mydriaticum or "mydrin m" or "mydrin p" or Mydrum or "n ethyl 2 phenyl n pyrid 4
ylmethylhydracrylamide" or "n ethyl n 4 picolyltropamide" or "n ethyl n gamma picolyltropamide" or "n ethyl n pyrid 4 ylmethyltropamide"
Informed decisions.
or "Ocu-Tropic" or OcuTropic or opticyl or sandol or sintropic or "tropamid forte" or "tropic acid n ethyl n gamma picolyl amide" or
Tropicacyl or tropicamid or "tropico eye" or tropicol or tropikamid or tropimil or visumidriatic or "1508-75-4"
#44 MeSH descriptor: [Tyramine] explode all trees
#45 Tyramine or "4 hydroxyphenethylamine" or lyramine or mydrial or "para hydroxyphenethylamine" or paratyramine or systogene or
tiramine or tocosine or tyramin or tyrosamine or uteramine or "51-67-2" or "60-19-5"
#46 Vibrocil or "8059-14-1"
#47 MeSH descriptor: [Yohimbine] explode all trees
#48 Yohimbine or actibine or aphrodine or aphrodyne or Corynanthine or "corynine hydrochloride" or "dayto-himbin" or "methyl
yohimbine 16alpha carboxylate" or "methylyohimbane 16alpha carboxylate" or Pluriviron or quebrachin or "quebrachine hydrochloride"
or Rauhimbine or Rauwolscine or urobine or yobin or yobinol or yocan or yocaral or Yocon or yocon or yohimbe or "yohimbic acid methyl
ester" or yohimbin or Yohimex or yohimex or yohimibin or yovital or "146-48-5" or "65-19-0"
#49 {or #9-#48}
#50 #8 and #49
Appendix 2. MEDLINE Ovid search strategy

1. Randomized Controlled Trial.pt.
2. Controlled Clinical Trial.pt.
3. (randomized or randomised).ab,ti.
4. placebo.ab,ti.
5. drug therapy.fs.
6. randomly.ab,ti.
7. trial.ab,ti.
8. groups.ab,ti.
9. 1 or 2 or 3 or 4 or 5 or 6 or 7 or 8
10. exp animals/ not humans.sh.
11. 9 not 10
12. exp Uveitis/
13. Iridocycliti*.tw.
14. (iritis* or iritide*).tw.
15. Cycliti*.tw.
16. scleriti*.tw.
17. uveiti*.tw.
18. ((sclera or iris or ciliary) and inflam*).tw.
19. or/12-18
20. exp Mydriatics/
21. mydriatic*.tw.
22. cycloplegic*.tw.
23. exp Atropine/
24. (Atropine or atrinal or "atro-polygyl" or atrop or atropen or atropin or atropina or "atropini sulfas" or atropinol or atropisol or atropt or
atroptol or atrospan or "atrosulf-1" or "bar bropin" or "bellpino-artin" or "cendo tropine" or "dextro levo hyosciamine" or "ichtho bellol"
or "isopto" or isoptoAtropine or "ocu-tropine" or "sal-tropine" or skiatropine or "tropine dextro levo tropate" or ximex or "51-55-8" or
"55-48-1").tw.
25. ("51-55-8" or "55-48-1").rn.
26. (berefrine or POPD or "105567-83-7").tw.
27. "105567-83-7".rn.
28. exp Cyclopentolate/
29. (Cyclopentolate or "ak-pentolate" or akpentolate or "bell pentolate" or ciclolux or cyclogyl or cyclomydri or cyclopentol or
or "refractyl ofeno" or skiacol or zyklolat or "512-15-2" or "5870-29-1").tw.
30. ("512-15-2" or "5870-29-1").rn.
31. exp Epinephrine/
32. (Epinephrine or Adrenaline or adrenalin or Epitrate or Lyophrin or Epifrin or adnephrin or adnephrine or "adrenal hydrochloride" or
adrenalina or adrenamine or adrenapax or adrenazin or adrenine or adrin or adrine or advaradin or balmadren or biorenine or bosmin or
chelafrin or dylephrin or epiglaufrin or epimephrine or epinefrina or epinephran or epinephrin or epirenamine or epirenan or exadrin or
glaucon or glaucosan or glaufrin or "glin epin" or glycirenan or haemostatin or hemisine or hemostasin or hemostatin or hypernephrin
or methylarterenol or mucidrina or myosthenine or "n methylnoradrenalin" or nephridine or nieraline or paranephrin or posumin or
vasoconstrictine or vasodrine or vasotonin or weradren or "51-43-4" or "55-31-2" or "6912-68-1").tw.

Informed decisions.
33. ("51-43-4" or "55-31-2" or "6912-68-1").rn.

34. exp Ethylmorphine/
35. (Ethylmorphine or Ethomorphine or Trachyl or codethyline or diolan or dionine or "ethyl morphine" or ethylmorfine or ethylmorphin
or "morphine ethyl ether" or "125-30-4" or "76-58-4").tw.
36. ("125-30-4" or "76-58-4").rn.
37. (Eucatropine or euphthalmine or "100-91-4" or "536-93-6").tw.
38. ("100-91-4" or "536-93-6").rn.
39. (Homatropine or homatro or homatrocil or homatropaire or homatropin or homatropina or isoptoHomatropine or "I Homatrine" or
"mandelyl tropeine" or mandelyltropeine or "mydryn eye" or "omatropina lux" or "tropine mandelate" or "51-56-9" or "87-00-3").tw.
40. ("51-56-9" or "87-00-3").rn.
41. exp Hyoscyamine/
42. (Hyoscyamine or anaspaz or cystospaz or cytospaz or daturine or donnamar or duboisine or egacen or hyoscamine or hyosciamine or
hyoscyanin or hyosyne or "ib-stat" or levbid or levsin or "levsinex sr" or neosol or nulev or spasdel or "symax sl" or "symax sr" or "tropine
l tropate" or "101-31-5" or "306-03-6").tw.
43. ("101-31-5" or "306-03-6").rn.
44. (Ibopamine or "N-methyldopamine diisobutyrate" or "SB 7505" or "SB7505" or Escandine or Inopamil or "diisobutyric n
methyldopamine ester" or scandine or "skf 100168" or "skf 100168 a" or "66195-31-1" or "75011-65-3").tw.
45. ("66195-31-1" or "75011-65-3").rn.
46. (Methylatropine or "8-methylatropinium nitrate" or "31610-87-4").tw.
47. "31610-87-4".rn.
48. exp Naphazoline/
49. (Naphazoline or "Afazol Grin" or "AK Con" or AKCon or Albalon or albasol or "All Clear" or allersol or antan or benil or cefasan or "Clear
"550-99-2" or "835-31-4").tw.
50. ("5144-52-5" or "550-99-2" or "835-31-4").rn.
51. (Oxedrine or Synephrine or Sympaethamin or Synephrin or aetaphen or pentedrine or vasoton or "94-07-5").tw.
52. "94-07-5".rn.
53. exp Synephrine/
54. exp Oxyphenonium/
55. (Oxyphenonium or Methacin or Oxyphenon or Atrenyl or Spastrex or antrenyl or "ba 5473" or ba5473 or "c 5473" or c5473 or helkamon
or metacin or metacinum or oxyphenium or "oxyphenomium bromide" or spasmofen or spasmophen or "14214-84-7" or "50-10-2").tw.
56. ("14214-84-7" or "50-10-2").rn.
57. exp Phenylephrine/
58. (Phenylephrine or adrianol or "af-taf" or "ak-dilate" or "albalon relief" or alconefrin or almefrin or altafrin or biomidrin or biomydrin
or "slv 325" or slv325 or sucraphen or vazculep or visadron or vistafrin or vistosan or "532-38-7" or "59-42-7" or "61-76-7").tw.
59. ("532-38-7" or "59-42-7" or "61-76-7").rn.
60. (Pholedrine or "4 hydroxy n methylamphetamine" or "4 hydroxymethamphetamine" or adyston or "para hydroxymethamphetamine"
or "p-hydroxymethamphetamine" or paredrinol or "Pholedrin liquidum" or "Pholedrin-longo-Isis" or pulsotyl or venosan or veritol or
"370-14-9").tw.
61. "370-14-9".rn.
62. exp p-Hydroxyamphetamine/
63. (p-Hydroxyamphetamine or "1 para hydroxyphenyl 2 propylamine" or "alpha methyl para tyramine" or "alpha methyl tyramine" or
"dl 1 p hydroxyphenyl 2 propylamine" or "dl 1 para hydroxyphenyl 2 propylamine" or "dl p hydroxy alpha methylphenethylamine" or
pulsoton or "103-86-6" or "1518-86-1" or "306-21-8").tw.
64. ("103-86-6" or "1518-86-1" or "306-21-8").rn.
65. exp Racepinephrine/
66. (Racepinephrine or Micronefrin or micronefrine or Micronephrine or mikronephrin or racadrenalin or "Racepinefrine Hydrochloride"
or racinephrine or Vaponefrin or vaponefrine or vaponephrin or "329-65-7").tw.
67. "329-65-7".rn.
68. exp Scopolamine Hydrobromide/
Informed decisions.
69. (Scopolamine or "Boro Scopol" or BoroScopol or Hyoscine or Kwells or "levo hyoscinehydrobromide" or Scoburen or Scopace or scopos
or "Travacalm HO" or Vorigeno or "114-49-8" or atrochin or atroquin or atroscine or hyosceine or hysco or "l epoxytropine tropate" or "n
methylhyoscine" or oscine or scopalamine or "scopine tropate" or scopolamin or transcop or "tropic acid ester with scopine" or "138-12-5"
or "51-34-3" or "55-16-3").tw.
70. ("114-49-8" or "138-12-5" or "51-34-3" or "55-16-3").rn.
71. exp Tropicamide/
72. (Tropicamide or "alcon-mydril" or bistropamide or "cendo mydriatyl" or "Colircusi Tropicamida" or midriaticum or mydiacyl or
Tropicacyl or tropicamid or "tropico eye" or tropicol or tropikamid or tropimil or visumidriatic or "1508-75-4").tw.
73. "1508-75-4".rn.
74. exp Tyramine/
75. (Tyramine or "4 hydroxyphenethylamine" or lyramine or mydrial or "para hydroxyphenethylamine" or paratyramine or systogene or
tiramine or tocosine or tyramin or tyrosamine or uteramine or "51-67-2" or "60-19-5").tw.
76. ("51-67-2" or "60-19-5").rn.
77. (Vibrocil or "8059-14-1").tw.
78. "8059-14-1".rn.
79. exp Yohimbine/
80. (Yohimbine or actibine or aphrodine or aphrodyne or Corynanthine or "corynine hydrochloride" or "dayto-himbin" or "methyl
or Rauhimbine or Rauwolscine or urobine or yobin or yobinol or yocan or yocaral or Yocon or yocon or yohimbe or "yohimbic acid methyl
ester" or yohimbin or Yohimex or yohimex or yohimibin or yovital or "146-48-5" or "65-19-0").tw.
81. ("146-48-5" or "65-19-0").rn.
82. or/20-81
83. 19 and 82
84. 11 and 83
The search filter for trials at the beginning of the MEDLINE strategy is from the published paper by Glanville 2006.
Appendix 3. Embase.com search strategy

#1 'randomized controlled trial'/exp
#2 'randomization'/exp
#3 'double blind procedure'/exp
#4 'single blind procedure'/exp
#5 random*:ab,ti
#6 #1 OR #2 OR #3 OR #4 OR #5
#7 'animal'/exp OR 'animal experiment'/exp
#8 'human'/exp
#9 #7 AND #8
#10 #7 NOT #9
#11 #6 NOT #10
#12 'clinical trial'/exp
#13 (clin* NEAR/3 trial*):ab,ti
#14 ((singl* OR doubl* OR trebl* OR tripl*) NEAR/3 (blind* OR mask*)):ab,ti
#15 'placebo'/exp
#16 placebo*:ab,ti
#17 random*:ab,ti
#18 'experimental design'/exp
#19 'crossover procedure'/exp
#20 'control group'/exp
#21 'latin square design'/exp
#22 #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21
#23 #22 NOT #10
#24 #23 NOT #11
#25 'comparative study'/exp
#26 'evaluation'/exp
#27 'prospective study'/exp
#28 control*:ab,ti OR prospectiv*:ab,ti OR volunteer*:ab,ti
#29 #25 OR #26 OR #27 OR #28
#30 #29 NOT #10

Informed decisions.
#31 #30 NOT (#11 OR #23)

#32 #11 OR #24 OR #31
#33 'uveitis'/exp
#34 Iridocycliti*:ti,ab
#35 (iritis* OR iritide*):ti,ab
#36 Cycliti*:ti,ab
#37 scleriti*:ti,ab
#38 uveiti*:ti,ab
#39 ((sclera OR iris OR ciliary) AND inflam*):ti,ab
#40 #33 OR #34 OR #35 OR #36 OR #37 OR #38 OR #39
#41 'mydriatic agent'/exp
#42 mydriatic*:ti,ab
#43 cycloplegic*:ti,ab
#44 (Atropine OR atrinal OR "atro-polygyl" OR atrop OR atropen OR atropin OR atropina OR "atropini sulfas" OR atropinol OR atropisol
OR atropt OR atroptol OR atrospan OR "atrosulf-1" OR "bar bropin" OR "bellpino-artin" OR "cendo tropine" OR "dextro levo hyosciamine"
OR "ichtho bellol" OR "isopto" OR isoptoAtropine OR "ocu-tropine" OR "sal-tropine" OR skiatropine OR "tropine dextro levo tropate" OR
ximex OR "51-55-8" OR "55-48-1"):ab,ti,tn
#45 (berefrine OR POPD OR "105567-83-7"):ab,ti,tn
#46 (Cyclopentolate OR "ak-pentolate" OR akpentolate OR "bell pentolate" OR ciclolux OR cyclogyl OR cyclomydri OR cyclopentol OR
cyclopentolat OR cylate OR cyplegin OR diopentolate OR midriodavi OR mydrilate OR "ocu-pentolate" OR ocucyclo OR "oftan-syklo" OR
pentolair OR "refractyl ofeno" OR skiacol OR zyklolat OR "512-15-2" OR "5870-29-1"):ab,ti,tn
#47 'epinephrine'/exp
#48 (Epinephrine OR Adrenaline OR adrenalin OR Epitrate OR Lyophrin OR Epifrin OR adnephrin OR adnephrine OR "adrenal hydrochloride"
OR adrenalina OR adrenamine OR adrenapax OR adrenazin OR adrenine OR adrin OR adrine OR advaradin OR balmadren OR biorenine
OR bosmin OR chelafrin OR dylephrin OR epiglaufrin OR epimephrine OR epinefrina OR epinephran OR epinephrin OR epirenamine OR
epirenan OR exadrin OR glaucon OR glaucosan OR glaufrin OR "glin epin" OR glycirenan OR haemostatin OR hemisine OR hemostasin OR
hemostatin OR hypernephrin OR "isopto epinal" OR levoadrenalin OR levoadrenaline OR levoepinephrine OR levorenin OR levorenine OR
methylaminoethanolcatechol OR methylarterenol OR mucidrina OR myosthenine OR "n methylnoradrenalin" OR nephridine OR nieraline
OR paranephrin OR posumin OR renaglandin OR renaglandulin OR renaleptine OR renalina OR renaline OR renoform OR renostypticin
OR renostyptin OR scurenaline OR simplene OR soladren OR sphygmogenin OR styptirenal OR supracapsulin OR supranephrane OR
supranephrin OR supranol OR suprarenaline OR suprarenin OR suprarenine OR suprel OR surenine OR surrenine OR "sus-phrine sulfite-
free" OR susphrine OR "sympathin I" OR takamina OR tonogen OR vasoconstrictine OR vasodrine OR vasotonin OR weradren OR "51-43-4"
OR "55-31-2" OR "6912-68-1"):ab,ti,tn
#49 (Ethylmorphine OR Ethomorphine OR Trachyl OR codethyline OR diolan OR dionine OR "ethyl morphine" OR ethylmorfine OR
ethylmorphin OR "morphine ethyl ether" OR "125-30-4" OR "76-58-4"):ab,ti,tn
#50 (Eucatropine OR euphthalmine OR "100-91-4" OR "536-93-6"):ab,ti,tn
#51 (Homatropine OR homatro OR homatrocil OR homatropaire OR homatropin OR homatropina OR isoptoHomatropine OR "I Homatrine"
OR "mandelyl tropeine" OR mandelyltropeine OR "mydryn eye" OR "omatropina lux" OR "tropine mandelate" OR "51-56-9" OR
"87-00-3"):ab,ti,tn
#52 'hyoscyamine'/exp
#53 (Hyoscyamine OR anaspaz OR cystospaz OR cytospaz OR daturine OR donnamar OR duboisine OR egacen OR hyoscamine OR
hyosciamine OR hyoscyanin OR hyosyne OR "ib-stat" OR levbid OR levsin OR "levsinex sr" OR neosol OR nulev OR spasdel OR "symax sl"
OR "symax sr" OR "tropine l tropate" OR "101-31-5" OR "306-03-6"):ab,ti,tn
#54 'ibopamine'/exp
#55 (Ibopamine OR "N-methyldopamine diisobutyrate" OR "SB 7505" OR "SB7505" OR Escandine OR Inopamil OR "diisobutyric n
methyldopamine ester" OR scandine OR "skf 100168" OR "skf 100168 a" OR "66195-31-1" OR "75011-65-3"):ti,ab,tn
#56 (Methylatropine OR "8-methylatropinium nitrate" OR "31610-87-4"):ti,ab,tn
#57 (Naphazoline OR "Afazol Grin" OR "AK Con" OR AKCon OR Albalon OR albasol OR "All Clear" OR allersol OR antan OR benil OR cefasan
OR "Clear Eyes" OR coldan OR "Colirio Alfa" OR "comfort eye drops" OR dazolin OR "degest 2" OR derinox OR Idril OR imidin OR minha
OR Miraclar OR mirafrin OR Nafazair OR nafazoline OR naftazolina OR "naphacel ofteno" OR naphasal OR naphazolin OR Naphcon OR
"naphozoline hydrochloride" OR naphtears OR naphthazoline OR naphthizine OR naphthyzin OR nastizol OR "nazil ofteno" OR niazol OR
"ocu-zoline" OR opcon OR Optazine OR Privin OR privina OR Privine OR privine OR Proculin OR rhinantin OR rhinazin OR rhinoperd OR
rimidol OR sanorin OR sanotin OR Siozwo OR strictylon OR "Tele Stulln" OR TeleStulln OR Vasoclear OR Vasocon OR "Vasoconstrictor Pensa"
OR VasoNit OR vistalbalon OR vistobalon OR "5144-52-5" OR "550-99-2" OR "835-31-4"):ti,ab,tn
#58 (Oxedrine OR Synephrine OR Sympaethamin OR Synephrin OR aetaphen OR pentedrine OR vasoton OR "94-07-5"):ti,ab,tn
#59 'oxyphenonium bromide'/exp
#60 (Oxyphenonium OR Methacin OR Oxyphenon OR Atrenyl OR Spastrex OR antrenyl OR "ba 5473" OR ba5473 OR "c 5473" OR c5473 OR
helkamon OR metacin OR metacinum OR oxyphenium OR "oxyphenomium bromide" OR spasmofen OR spasmophen OR "14214-84-7" OR
"50-10-2"):ab,ti,tn
#61 (Phenylephrine OR adrianol OR "af-taf" OR "ak-dilate" OR "albalon relief" OR alconefrin OR almefrin OR altafrin OR biomidrin OR
biomydrin OR derizene OR "despec-sf" OR drosin OR "efrin-10" OR efrisel OR fenylephrine OR idrianol OR isonefrine OR isophrin OR
isophrine OR "isopto frin" OR isoptofrin OR lexatol OR "m synephrine" OR mesaton OR "meta sympathol" OR "meta synephrine" OR
Informed decisions.
Metaoxedrin OR metaoxedrine OR Metasympatol OR metasynephrine OR Mezaton OR "murucoll 2" OR mydfrin OR "n 105 to" OR "nefrin-
ofteno" OR "Neo Synephrine" OR neofrin OR neooxedrine OR neophryn OR neosynephrin OR Neosynephrine OR "neosynephrin-pos" OR
neosynesin OR neosynesine OR "ocu-phrin" OR "oftan-metaoksedrin" OR optistin OR phenoptic OR phenylefrine OR phenylephedrine OR
prefrin OR "pupiletto forte" OR rectasol OR "rhinall 10" OR "slv 325" OR slv325 OR sucraphen OR vazculep OR visadron OR vistafrin OR
vistosan OR "532-38-7" OR "59-42-7" OR "61-76-7"):ti,ab,tn
#62 (Pholedrine OR "4 hydroxy n methylamphetamine" OR "4 hydroxymethamphetamine" OR adyston OR "para
hydroxymethamphetamine" OR "p-hydroxymethamphetamine" OR paredrinol OR "Pholedrin liquidum" OR "Pholedrin-longo-Isis" OR
pulsotyl OR venosan OR veritol OR "370-14-9"):ti,ab,tn
#63 'hydroxyamphetamine'/exp
#64 (p-Hydroxyamphetamine OR "1 para hydroxyphenyl 2 propylamine" OR "alpha methyl para tyramine" OR "alpha methyl tyramine" OR
"dl 1 p hydroxyphenyl 2 propylamine" OR "dl 1 para hydroxyphenyl 2 propylamine" OR "dl p hydroxy alpha methylphenethylamine" OR
"dl para hydroxy alpha methylphenethylamine" OR "h 66 37" OR "para hydroxy alpha methylphenethylamine" OR Hydroxyamfetamine OR
Hydroxyamphetamin OR Hydroxyamphetamine OR Hydroxyphenylisopropylamine OR Methyltyramine OR Norpholedrin OR norpholedrine
OR oxamphetamine OR Oxyamphetamine OR paradrine OR parahydroxyamphetamine OR Paredrine OR paredrinea OR paredrinex OR
pedrolone OR pulsoton OR "103-86-6" OR "1518-86-1" OR "306-21-8"):ab,ti,tn
#65 'racepinefrine'/exp
#66 (Racepinephrine OR Micronefrin OR micronefrine OR Micronephrine OR mikronephrin OR racadrenalin OR "Racepinefrine
Hydrochloride" OR racinephrine OR Vaponefrin OR vaponefrine OR vaponephrin OR "329-65-7"):ti,ab,tn
#67 'scopolamine bromide'/exp
#68 (Scopolamine OR "Boro Scopol" OR BoroScopol OR Hyoscine OR Kwells OR "levo hyoscinehydrobromide" OR Scoburen OR Scopace OR
scopos OR "Travacalm HO" OR Vorigeno OR "114-49-8" OR atrochin OR atroquin OR atroscine OR hyosceine OR hysco OR "l epoxytropine
tropate" OR "n methylhyoscine" OR oscine OR scopalamine OR "scopine tropate" OR scopolamin OR transcop OR "tropic acid ester with
scopine" OR "138-12-5" OR "51-34-3" OR "55-16-3"):ab,ti,tn
#69 (Tropicamide OR "alcon-mydril" OR bistropamide OR "cendo mydriatyl" OR "Colircusi Tropicamida" OR midriaticum OR mydiacyl
OR mydral OR mydramide OR mydriacyl OR Mydriafair OR Mydriaticum OR "mydrin m" OR "mydrin p" OR Mydrum OR "n ethyl 2 phenyl
n pyrid 4 ylmethylhydracrylamide" OR "n ethyl n 4 picolyltropamide" OR "n ethyl n gamma picolyltropamide" OR "n ethyl n pyrid 4
ylmethyltropamide" OR "Ocu-Tropic" OR OcuTropic OR opticyl OR sandol OR sintropic OR "tropamid forte" OR "tropic acid n ethyl
n gamma picolyl amide" OR Tropicacyl OR tropicamid OR "tropico eye" OR tropicol OR tropikamid OR tropimil OR visumidriatic OR
"1508-75-4"):ab,ti,tn
#70 (Tyramine OR "4 hydroxyphenethylamine" OR lyramine OR mydrial OR "para hydroxyphenethylamine" OR paratyramine OR systogene
OR tiramine OR tocosine OR tyramin OR tyrosamine OR uteramine OR "51-67-2" OR "60-19-5"):ti,ab,tn
#71 (Vibrocil OR "8059-14-1"):ti,ab,tn
#72 'yohimbine'/exp
#73 (Yohimbine OR actibine OR aphrodine OR aphrodyne OR Corynanthine OR "corynine hydrochloride" OR "dayto-himbin" OR
"methyl yohimbine 16alpha carboxylate" OR "methylyohimbane 16alpha carboxylate" OR Pluriviron OR quebrachin OR "quebrachine
hydrochloride" OR Rauhimbine OR Rauwolscine OR urobine OR yobin OR yobinol OR yocan OR yocaral OR Yocon OR yocon OR yohimbe
OR "yohimbic acid methyl ester" OR yohimbin OR Yohimex OR yohimex OR yohimibin OR yovital OR "146-48-5" OR "65-19-0"):ti,ab,tn
#74 #41 OR #42 OR #43 OR #44 OR #45 OR #46 OR #47 OR #48 OR #49 OR #50 OR #51 OR #52 OR #53 OR #54 OR #55 OR #56 OR #57 OR #58
OR #59 OR #60 OR #61 OR #62 OR #63 OR #64 OR #65 OR #66 OR #67 OR #68 OR #69 OR #70 OR #71 OR #72 OR #73
#75 #40 AND #74
#76 #32 AND #75
Appendix 4. CINAHL search strategy

S1 (MH "Uveitis+")
S2 TI Iridocycliti* OR AB Iridocycliti*
S3 TI ( iritis* or iritide* ) OR AB ( iritis* or iritide*)
S4 TI Cycliti* OR AB Cycliti*
S5 TI scleriti* OR AB scleriti*
S6 TI uveiti* OR AB uveiti*
S7 TI ( (sclera or iris or ciliary) and (inflam*) ) OR AB ( (sclera or iris or ciliary) and (inflam*) )
S8 S1 OR S2 OR S3 OR S4 OR S5 OR S6 OR S7
S9 (MH "Mydriatics+")
S10 TI mydriatic* OR AB mydriatic*
S11 TI cycloplegic* OR AB cycloplegic*
S12 TI ( Atropine or atrinal or "atro-polygyl" or atrop or atropen or atropin or atropina or "atropini sulfas" or atropinol or atropisol
or atropt or atroptol or atrospan or "atrosulf-1" or "bar bropin" or "bellpino-artin" or "cendo tropine" or "dextro levo hyosciamine" or
"ichtho bellol" or "isopto" or isoptoAtropine or "ocu-tropine" or "sal-tropine" or skiatropine or "tropine dextro levo tropate" or ximex
or "51-55-8" or "55-48-1" ) OR AB ( Atropine or atrinal or "atro-polygyl" or atrop or atropen or atropin or atropina or "atropini sulfas" or
atropinol or atropisol or atropt or atroptol or atrospan or "atrosulf-1" or "bar bropin" or "bellpino-artin" or "cendo tropine" or "dextro
levo hyosciamine" or "ichtho bellol" or "isopto" or isoptoAtropine or "ocu-tropine" or "sal-tropine" or skiatropine or "tropine dextro levo
tropate" or ximex or "51-55-8" or "55-48-1" )

Informed decisions.
S13 TI (berefrine or POPD or "105567-83-7") OR AB (berefrine or POPD or "105567-83-7")

S14 TI (Cyclopentolate or "ak-pentolate" or akpentolate or "bell pentolate" or ciclolux or cyclogyl or cyclomydri or cyclopentol or
or "refractyl ofeno" or skiacol or zyklolat or "512-15-2" or "5870-29-1") OR AB (Cyclopentolate or "ak-pentolate" or akpentolate or "bell
pentolate" or ciclolux or cyclogyl or cyclomydri or cyclopentol or cyclopentolat or cylate or cyplegin or diopentolate or midriodavi
or mydrilate or "ocu-pentolate" or ocucyclo or "oftan-syklo" or pentolair or "refractyl ofeno" or skiacol or zyklolat or "512-15-2" or
"5870-29-1")
S15 TI (Epinephrine or Adrenaline or adrenalin or Epitrate or Lyophrin or Epifrin or adnephrin or adnephrine or "adrenal hydrochloride"
or adrenalina or adrenamine or adrenapax or adrenazin or adrenine or adrin or adrine or advaradin or balmadren or biorenine or bosmin
or chelafrin or dylephrin or epiglaufrin or epimephrine or epinefrina or epinephran or epinephrin or epirenamine or epirenan or exadrin
or glaucon or glaucosan or glaufrin or "glin epin" or glycirenan or haemostatin or hemisine or hemostasin or hemostatin or hypernephrin
or methylarterenol or mucidrina or myosthenine or "n methylnoradrenalin" or nephridine or nieraline or paranephrin or posumin
or renaglandin or renaglandulin or renaleptine or renalina or renaline or renoform or renostypticin or renostyptin or scurenaline or
simplene or soladren or sphygmogenin or styptirenal or supracapsulin or supranephrane or supranephrin or supranol or suprarenaline
or suprarenin or suprarenine or suprel or surenine or surrenine or "sus-phrine sulfite-free" or susphrine or "sympathin I" or takamina
or tonogen or vasoconstrictine or vasodrine or vasotonin or weradren or "51-43-4" or "55-31-2" or "6912-68-1") OR AB (Epinephrine
or Adrenaline or adrenalin or Epitrate or Lyophrin or Epifrin or adnephrin or adnephrine or "adrenal hydrochloride" or adrenalina or
adrenamine or adrenapax or adrenazin or adrenine or adrin or adrine or advaradin or balmadren or biorenine or bosmin or chelafrin
or dylephrin or epiglaufrin or epimephrine or epinefrina or epinephran or epinephrin or epirenamine or epirenan or exadrin or glaucon
or glaucosan or glaufrin or "glin epin" or glycirenan or haemostatin or hemisine or hemostasin or hemostatin or hypernephrin or
"isopto epinal" or levoadrenalin or levoadrenaline or levoepinephrine or levorenin or levorenine or methylaminoethanolcatechol or
methylarterenol or mucidrina or myosthenine or "n methylnoradrenalin" or nephridine or nieraline or paranephrin or posumin or
vasoconstrictine or vasodrine or vasotonin or weradren or "51-43-4" or "55-31-2" or "6912-68-1")
S16 TI (Ethylmorphine or Ethomorphine or Trachyl or codethyline or diolan or dionine or "ethyl morphine" or ethylmorfine or ethylmorphin
or "morphine ethyl ether" or "125-30-4" or "76-58-4") OR AB (Ethylmorphine or Ethomorphine or Trachyl or codethyline or diolan or dionine
or "ethyl morphine" or ethylmorfine or ethylmorphin or "morphine ethyl ether" or "125-30-4" or "76-58-4")
S17 TI (Eucatropine or euphthalmine or "100-91-4" or "536-93-6") OR AB (Eucatropine or euphthalmine or "100-91-4" or "536-93-6")
S18 TI (Homatropine or homatro or homatrocil or homatropaire or homatropin or homatropina or isoptoHomatropine or "I Homatrine"
or "mandelyl tropeine" or mandelyltropeine or "mydryn eye" or "omatropina lux" or "tropine mandelate" or "51-56-9" or "87-00-3) OR
AB (Homatropine or homatro or homatrocil or homatropaire or homatropin or homatropina or isoptoHomatropine or "I Homatrine" or
"mandelyl tropeine" or mandelyltropeine or "mydryn eye" or "omatropina lux" or "tropine mandelate" or "51-56-9" or "87-00-3)
S19 TI (Hyoscyamine or anaspaz or cystospaz or cytospaz or daturine or donnamar or duboisine or egacen or hyoscamine or hyosciamine
or hyoscyanin or hyosyne or "ib-stat" or levbid or levsin or "levsinex sr" or neosol or nulev or spasdel or "symax sl" or "symax sr" or "tropine
l tropate" or "101-31-5" or "306-03-6") OR AB (Hyoscyamine or anaspaz or cystospaz or cytospaz or daturine or donnamar or duboisine
or egacen or hyoscamine or hyosciamine or hyoscyanin or hyosyne or "ib-stat" or levbid or levsin or "levsinex sr" or neosol or nulev or
spasdel or "symax sl" or "symax sr" or "tropine l tropate" or "101-31-5" or "306-03-6")
S20 TI (Ibopamine or "N-methyldopamine diisobutyrate" or "SB 7505" or "SB7505" or Escandine or Inopamil or "diisobutyric n
methyldopamine ester" or scandine or "skf 100168" or "skf 100168 a" or "66195-31-1" or "75011-65-3") OR AB (Ibopamine or "N-
methyldopamine diisobutyrate" or "SB 7505" or "SB7505" or Escandine or Inopamil or "diisobutyric n methyldopamine ester" or scandine
or "skf 100168" or "skf 100168 a" or "66195-31-1" or "75011-65-3")
S21 TI (Methylatropine or "8-methylatropinium nitrate" or "31610-87-4") OR AB (Methylatropine or "8-methylatropinium nitrate" or
"31610-87-4")
S22 TI (Naphazoline or "Afazol Grin" or "AK Con" or AKCon or Albalon or albasol or "All Clear" or allersol or antan or benil or cefasan or "Clear
"550-99-2" or "835-31-4") OR AB (Naphazoline or "Afazol Grin" or "AK Con" or AKCon or Albalon or albasol or "All Clear" or allersol or antan
or benil or cefasan or "Clear Eyes" or coldan or "Colirio Alfa" or "comfort eye drops" or dazolin or "degest 2" or derinox or Idril or imidin
or minha or Miraclar or mirafrin or Nafazair or nafazoline or naftazolina or "naphacel ofteno" or naphasal or naphazolin or Naphcon or
"naphozoline hydrochloride" or naphtears or naphthazoline or naphthizine or naphthyzin or nastizol or "nazil ofteno" or niazol or "ocu-
zoline" or opcon or Optazine or Privin or privina or Privine or privine or Proculin or rhinantin or rhinazin or rhinoperd or rimidol or sanorin
or sanotin or Siozwo or strictylon or "Tele Stulln" or TeleStulln or Vasoclear or Vasocon or "Vasoconstrictor Pensa" or VasoNit or vistalbalon
or vistobalon or "5144-52-5" or "550-99-2" or "835-31-4")
S23 TI (Oxedrine or Synephrine or Sympaethamin or Synephrin or aetaphen or pentedrine or vasoton or "94-07-5") OR AB (Oxedrine or
Synephrine or Sympaethamin or Synephrin or aetaphen or pentedrine or vasoton or "94-07-5")

Informed decisions.
S24 TI (Oxyphenonium or Methacin or Oxyphenon or Atrenyl or Spastrex or antrenyl or "ba 5473" or ba5473 or "c 5473" or c5473 or helkamon
or metacin or metacinum or oxyphenium or "oxyphenomium bromide" or spasmofen or spasmophen or "14214-84-7" or "50-10-2") OR AB
(Oxyphenonium or Methacin or Oxyphenon or Atrenyl or Spastrex or antrenyl or "ba 5473" or ba5473 or "c 5473" or c5473 or helkamon or
metacin or metacinum or oxyphenium or "oxyphenomium bromide" or spasmofen or spasmophen or "14214-84-7" or "50-10-2")
S25 TI (Phenylephrine or adrianol or "af-taf" or "ak-dilate" or "albalon relief" or alconefrin or almefrin or altafrin or biomidrin or biomydrin
"oftan-metaoksedrin" or optistin or phenoptic or phenylefrine or phenylephedrine or prefrin or "pupiletto forte" or rectasol or "rhinall
10" or "slv 325" or slv325 or sucraphen or vazculep or visadron or vistafrin or vistosan or "532-38-7" or "59-42-7" or "61-76-7") OR AB
(Phenylephrine or adrianol or "af-taf" or "ak-dilate" or "albalon relief" or alconefrin or almefrin or altafrin or biomidrin or biomydrin or
derizene or "despec-sf" or drosin or "efrin-10" or efrisel or fenylephrine or idrianol or isonefrine or isophrin or isophrine or "isopto frin"
or isoptofrin or lexatol or "m synephrine" or mesaton or "meta sympathol" or "meta synephrine" or Metaoxedrin or metaoxedrine or
or "slv 325" or slv325 or sucraphen or vazculep or visadron or vistafrin or vistosan or "532-38-7" or "59-42-7" or "61-76-7")
S26 TI (Pholedrine or "4 hydroxy n methylamphetamine" or "4 hydroxymethamphetamine" or adyston or "para
hydroxymethamphetamine" or "p-hydroxymethamphetamine" or paredrinol or "Pholedrin liquidum" or "Pholedrin-longo-Isis" or pulsotyl
or venosan or veritol or "370-14-9") OR AB (Pholedrine or "4 hydroxy n methylamphetamine" or "4 hydroxymethamphetamine" or adyston
or "para hydroxymethamphetamine" or "p-hydroxymethamphetamine" or paredrinol or "Pholedrin liquidum" or "Pholedrin-longo-Isis"
or pulsotyl or venosan or veritol or "370-14-9")
S27 TI (p-Hydroxyamphetamine or "1 para hydroxyphenyl 2 propylamine" or "alpha methyl para tyramine" or "alpha methyl tyramine"
or "dl 1 p hydroxyphenyl 2 propylamine" or "dl 1 para hydroxyphenyl 2 propylamine" or "dl p hydroxy alpha methylphenethylamine" or
pulsoton or "103-86-6" or "1518-86-1" or "306-21-8") OR AB (p-Hydroxyamphetamine or "1 para hydroxyphenyl 2 propylamine" or "alpha
methyl para tyramine" or "alpha methyl tyramine" or "dl 1 p hydroxyphenyl 2 propylamine" or "dl 1 para hydroxyphenyl 2 propylamine"
or "dl p hydroxy alpha methylphenethylamine" or "dl para hydroxy alpha methylphenethylamine" or "h 66 37" or "para hydroxy alpha
methylphenethylamine" or Hydroxyamfetamine or Hydroxyamphetamin or Hydroxyamphetamine or Hydroxyphenylisopropylamine or
Methyltyramine or Norpholedrin or norpholedrine or oxamphetamine or Oxyamphetamine or paradrine or parahydroxyamphetamine or
Paredrine or paredrinea or paredrinex or pedrolone or pulsoton or "103-86-6" or "1518-86-1" or "306-21-8")
S28 TI (Racepinephrine or Micronefrin or micronefrine or Micronephrine or mikronephrin or racadrenalin or "Racepinefrine Hydrochloride"
or racinephrine or Vaponefrin or vaponefrine or vaponephrin or "329-65-7") OR AB (Racepinephrine or Micronefrin or micronefrine
or Micronephrine or mikronephrin or racadrenalin or "Racepinefrine Hydrochloride" or racinephrine or Vaponefrin or vaponefrine or
vaponephrin or "329-65-7")
S29 TI (Scopolamine or "Boro Scopol" or BoroScopol or Hyoscine or Kwells or "levo hyoscinehydrobromide" or Scoburen or Scopace
or scopos or "Travacalm HO" or Vorigeno or "114-49-8" or atrochin or atroquin or atroscine or hyosceine or hysco or "l epoxytropine
tropate" or "n methylhyoscine" or oscine or scopalamine or "scopine tropate" or scopolamin or transcop or "tropic acid ester with
scopine" or "138-12-5" or "51-34-3" or "55-16-3") OR AB (Scopolamine or "Boro Scopol" or BoroScopol or Hyoscine or Kwells or "levo
hyoscinehydrobromide" or Scoburen or Scopace or scopos or "Travacalm HO" or Vorigeno or "114-49-8" or atrochin or atroquin or
atroscine or hyosceine or hysco or "l epoxytropine tropate" or "n methylhyoscine" or oscine or scopalamine or "scopine tropate" or
scopolamin or transcop or "tropic acid ester with scopine" or "138-12-5" or "51-34-3" or "55-16-3")
S30 TI (Tropicamide or "alcon-mydril" or bistropamide or "cendo mydriatyl" or "Colircusi Tropicamida" or midriaticum or mydiacyl or
Tropicacyl or tropicamid or "tropico eye" or tropicol or tropikamid or tropimil or visumidriatic or "1508-75-4") OR AB (Tropicamide or
"alcon-mydril" or bistropamide or "cendo mydriatyl" or "Colircusi Tropicamida" or midriaticum or mydiacyl or mydral or mydramide or
mydriacyl or Mydriafair or Mydriaticum or "mydrin m" or "mydrin p" or Mydrum or "n ethyl 2 phenyl n pyrid 4 ylmethylhydracrylamide"
or "n ethyl n 4 picolyltropamide" or "n ethyl n gamma picolyltropamide" or "n ethyl n pyrid 4 ylmethyltropamide" or "Ocu-Tropic" or
OcuTropic or opticyl or sandol or sintropic or "tropamid forte" or "tropic acid n ethyl n gamma picolyl amide" or Tropicacyl or tropicamid
or "tropico eye" or tropicol or tropikamid or tropimil or visumidriatic or "1508-75-4")
S31 TI (Tyramine or "4 hydroxyphenethylamine" or lyramine or mydrial or "para hydroxyphenethylamine" or paratyramine or systogene
or tiramine or tocosine or tyramin or tyrosamine or uteramine or "51-67-2" or "60-19-5") OR AB (Tyramine or "4 hydroxyphenethylamine"
or lyramine or mydrial or "para hydroxyphenethylamine" or paratyramine or systogene or tiramine or tocosine or tyramin or tyrosamine
or uteramine or "51-67-2" or "60-19-5")
S32 TI (Vibrocil or "8059-14-1") OR AB (Vibrocil or "8059-14-1")
S33 (MH "Yohimbine")

Informed decisions.
S34 TI (Yohimbine or actibine or aphrodine or aphrodyne or Corynanthine or "corynine hydrochloride" or "dayto-himbin" or "methyl
or Rauhimbine or Rauwolscine or urobine or yobin or yobinol or yocan or yocaral or Yocon or yocon or yohimbe or "yohimbic acid
methyl ester" or yohimbin or Yohimex or yohimex or yohimibin or yovital or "146-48-5" or "65-19-0") OR AB (Yohimbine or actibine or
aphrodine or aphrodyne or Corynanthine or "corynine hydrochloride" or "dayto-himbin" or "methyl yohimbine 16alpha carboxylate" or
"methylyohimbane 16alpha carboxylate" or Pluriviron or quebrachin or "quebrachine hydrochloride" or Rauhimbine or Rauwolscine or
urobine or yobin or yobinol or yocan or yocaral or Yocon or yocon or yohimbe or "yohimbic acid methyl ester" or yohimbin or Yohimex or
yohimex or yohimibin or yovital or "146-48-5" or "65-19-0")
S35 (S9 OR S10 OR S11 OR S12 OR S13 OR S14 OR S15 OR S16 OR S17 OR S18 OR S19 OR S20 OR S21 OR S22 OR S23 OR S24 OR S25 OR S26
OR S27 OR S28 OR S29 OR S30 OR S31 OR S32 OR S33 OR S34)
S36 S8 AND S35
Appendix 5. PubMed search strategy

#1 ((randomized controlled trial[pt]) OR (controlled clinical trial[pt]) OR (randomised[tiab] OR randomized[tiab]) OR (placebo[tiab]) OR
(drug therapy[sh]) OR (randomly[tiab]) OR (trial[tiab]) OR (groups[tiab])) NOT (animals[mh] NOT humans[mh])
#2 Iridocycliti*[tw]
#3 (iritis*[tw] OR iritide*[tw])
#4 Cycliti*[tw]
#5 scleriti*[tw]
#6 uveiti*[tw]
#7 ((sclera[tw] OR iris[tw] OR ciliary[tw]) AND inflam*[tw])
#8 #2 OR #3 OR #4 OR #5 OR #6 OR #7
#9 mydriatic*[tw]
#10 cycloplegic*[tw]
#11 (Atropine[tw] OR atrinal[tw] OR "atro-polygyl"[tw] OR atrop[tw] OR atropen[tw] OR atropin[tw] OR atropina[tw] OR "atropini
sulfas"[tw] OR atropinol[tw] OR atropisol[tw] OR atropt[tw] OR atroptol[tw] OR atrospan[tw] OR "atrosulf-1"[tw] OR "bar bropin"[tw]
OR "bellpino-artin"[tw] OR "cendo tropine"[tw] OR "dextro levo hyosciamine"[tw] OR "ichtho bellol"[tw] OR "isopto"[tw] OR
isoptoAtropine[tw] OR "ocu-tropine"[tw] OR "sal-tropine"[tw] OR skiatropine[tw] OR "tropine dextro levo tropate"[tw] OR ximex[tw] OR
"51-55-8"[tw] OR "55-48-1"[tw])
#12 (berefrine[tw] OR POPD[tw] OR "105567-83-7"[tw])
#13 (Cyclopentolate[tw] OR "ak-pentolate"[tw] OR akpentolate[tw] OR "bell pentolate"[tw] OR ciclolux[tw] OR cyclogyl[tw] OR
cyclomydri[tw] OR cyclopentol[tw] OR cyclopentolat[tw] OR cylate[tw] OR cyplegin[tw] OR diopentolate[tw] OR midriodavi[tw] OR
mydrilate[tw] OR "ocu-pentolate"[tw] OR ocucyclo[tw] OR "oftan-syklo"[tw] OR pentolair[tw] OR "refractyl ofeno"[tw] OR skiacol[tw] OR
zyklolat[tw] OR "512-15-2"[tw] OR "5870-29-1"[tw])
#14 (Epinephrine[tw] OR Adrenaline[tw] OR adrenalin[tw] OR Epitrate[tw] OR Lyophrin[tw] OR Epifrin[tw] OR adnephrin[tw] OR
adnephrine[tw] OR "adrenal hydrochloride"[tw] OR adrenalina[tw] OR adrenamine[tw] OR adrenapax[tw] OR adrenazin[tw] OR
adrenine[tw] OR adrin[tw] OR adrine[tw] OR advaradin[tw] OR balmadren[tw] OR biorenine[tw] OR bosmin[tw] OR chelafrin[tw] OR
dylephrin[tw] OR epiglaufrin[tw] OR epimephrine[tw] OR epinefrina[tw] OR epinephran[tw] OR epinephrin[tw] OR epirenamine[tw] OR
epirenan[tw] OR exadrin[tw] OR glaucon[tw] OR glaucosan[tw] OR glaufrin[tw] OR "glin epin"[tw] OR glycirenan[tw] OR haemostatin[tw]
OR hemisine[tw] OR hemostasin[tw] OR hemostatin[tw] OR hypernephrin[tw] OR "isopto epinal"[tw] OR levoadrenalin[tw]
OR levoadrenaline[tw] OR levoepinephrine[tw] OR levorenin[tw] OR levorenine[tw] OR methylaminoethanolcatechol[tw] OR
methylarterenol[tw] OR mucidrina[tw] OR myosthenine[tw] OR "n methylnoradrenalin"[tw] OR nephridine[tw] OR nieraline[tw] OR
paranephrin[tw] OR posumin[tw] OR renaglandin[tw] OR renaglandulin[tw] OR renaleptine[tw] OR renalina[tw] OR renaline[tw] OR
renoform[tw] OR renostypticin[tw] OR renostyptin[tw] OR scurenaline[tw] OR simplene[tw] OR soladren[tw] OR sphygmogenin[tw]
OR styptirenal[tw] OR supracapsulin[tw] OR supranephrane[tw] OR supranephrin[tw] OR supranol[tw] OR suprarenaline[tw] OR
suprarenin[tw] OR suprarenine[tw] OR suprel[tw] OR surenine[tw] OR surrenine[tw] OR "sus-phrine sulfite-free"[tw] OR susphrine[tw]
OR "sympathin I"[tw] OR takamina[tw] OR tonogen[tw] OR vasoconstrictine[tw] OR vasodrine[tw] OR vasotonin[tw] OR weradren[tw] OR
"51-43-4"[tw] OR "55-31-2"[tw] OR "6912-68-1"[tw])
#15 (Ethylmorphine[tw] OR Ethomorphine[tw] OR Trachyl[tw] OR codethyline[tw] OR diolan[tw] OR dionine[tw] OR "ethyl morphine"[tw]
OR ethylmorfine[tw] OR ethylmorphin[tw] OR "morphine ethyl ether"[tw] OR "125-30-4"[tw] OR "76-58-4"[tw])
#16 (Eucatropine[tw] OR euphthalmine[tw] OR "100-91-4"[tw] OR "536-93-6"[tw])
#17 (Homatropine[tw] OR homatro[tw] OR homatrocil[tw] OR homatropaire[tw] OR homatropin[tw] OR homatropina[tw] OR
isoptoHomatropine[tw] OR "I Homatrine"[tw] OR "mandelyl tropeine"[tw] OR mandelyltropeine[tw] OR "mydryn eye"[tw] OR "omatropina
lux"[tw] OR "tropine mandelate"[tw] OR "51-56-9"[tw] OR "87-00-3"[tw])
#18 (Hyoscyamine[tw] OR anaspaz[tw] OR cystospaz[tw] OR cytospaz[tw] OR daturine[tw] OR donnamar[tw] OR duboisine[tw] OR
egacen[tw] OR hyoscamine[tw] OR hyosciamine[tw] OR hyoscyanin[tw] OR hyosyne[tw] OR "ib-stat"[tw] OR levbid[tw] OR levsin[tw]
OR "levsinex sr"[tw] OR neosol[tw] OR nulev[tw] OR spasdel[tw] OR "symax sl"[tw] OR "symax sr"[tw] OR "tropine l tropate"[tw] OR
"101-31-5"[tw] OR "306-03-6"[tw])
#19 (Ibopamine[tw] OR "N-methyldopamine diisobutyrate"[tw] OR "SB 7505"[tw] OR "SB7505"[tw] OR Escandine[tw] OR Inopamil[tw]
OR "diisobutyric n methyldopamine ester"[tw] OR scandine[tw] OR "skf 100168"[tw] OR "skf 100168 a"[tw] OR "66195-31-1"[tw] OR
"75011-65-3"[tw])

Informed decisions.
#20 (Methylatropine[tw] OR "8-methylatropinium nitrate"[tw] OR "31610-87-4"[tw])

#21 (Naphazoline[tw] OR "Afazol Grin"[tw] OR "AK Con"[tw] OR AKCon[tw] OR Albalon[tw] OR albasol[tw] OR "All Clear"[tw] OR allersol[tw]
OR antan[tw] OR benil[tw] OR cefasan[tw] OR "Clear Eyes"[tw] OR coldan[tw] OR "Colirio Alfa"[tw] OR "comfort eye drops"[tw] OR
dazolin[tw] OR "degest 2"[tw] OR derinox[tw] OR Idril[tw] OR imidin[tw] OR minha[tw] OR Miraclar[tw] OR mirafrin[tw] OR Nafazair[tw]
OR nafazoline[tw] OR naftazolina[tw] OR "naphacel ofteno"[tw] OR naphasal[tw] OR naphazolin[tw] OR Naphcon[tw] OR "naphozoline
hydrochloride"[tw] OR naphtears[tw] OR naphthazoline[tw] OR naphthizine[tw] OR naphthyzin[tw] OR nastizol[tw] OR "nazil ofteno"[tw]
OR niazol[tw] OR "ocu-zoline"[tw] OR opcon[tw] OR Optazine[tw] OR Privin[tw] OR privina[tw] OR Privine[tw] OR privine[tw] OR
Proculin[tw] OR rhinantin[tw] OR rhinazin[tw] OR rhinoperd[tw] OR rimidol[tw] OR sanorin[tw] OR sanotin[tw] OR Siozwo[tw] OR
strictylon[tw] OR "Tele Stulln"[tw] OR TeleStulln[tw] OR Vasoclear[tw] OR Vasocon[tw] OR "Vasoconstrictor Pensa"[tw] OR VasoNit[tw] OR
vistalbalon[tw] OR vistobalon[tw] OR "5144-52-5"[tw] OR "550-99-2"[tw] OR "835-31-4"[tw])
#22 (Oxedrine[tw] OR Synephrine[tw] OR Sympaethamin[tw] OR Synephrin[tw] OR aetaphen[tw] OR pentedrine[tw] OR vasoton[tw] OR
"94-07-5"[tw])
#23 (Oxyphenonium[tw] OR Methacin[tw] OR Oxyphenon[tw] OR Atrenyl[tw] OR Spastrex[tw] OR antrenyl[tw] OR "ba 5473"[tw] OR
ba5473[tw] OR "c 5473"[tw] OR c5473[tw] OR helkamon[tw] OR metacin[tw] OR metacinum[tw] OR oxyphenium[tw] OR "oxyphenomium
bromide"[tw] OR spasmofen[tw] OR spasmophen[tw] OR "14214-84-7"[tw] OR "50-10-2"[tw])
#24 (Phenylephrine[tw] OR adrianol[tw] OR "af-taf"[tw] OR "ak-dilate"[tw] OR "albalon relief"[tw] OR alconefrin[tw] OR almefrin[tw] OR
altafrin[tw] OR biomidrin[tw] OR biomydrin[tw] OR derizene[tw] OR "despec-sf"[tw] OR drosin[tw] OR "efrin-10"[tw] OR efrisel[tw] OR
fenylephrine[tw] OR idrianol[tw] OR isonefrine[tw] OR isophrin[tw] OR isophrine[tw] OR "isopto frin"[tw] OR isoptofrin[tw] OR lexatol[tw]
OR "m synephrine"[tw] OR mesaton[tw] OR "meta sympathol"[tw] OR "meta synephrine"[tw] OR Metaoxedrin[tw] OR metaoxedrine[tw]
OR Metasympatol[tw] OR metasynephrine[tw] OR Mezaton[tw] OR "murucoll 2"[tw] OR mydfrin[tw] OR "n 105[tw] to" OR "nefrin-
ofteno"[tw] OR "Neo Synephrine"[tw] OR neofrin[tw] OR neooxedrine[tw] OR neophryn[tw] OR neosynephrin[tw] OR Neosynephrine[tw]
OR "neosynephrin-pos"[tw] OR neosynesin[tw] OR neosynesine[tw] OR "ocu-phrin"[tw] OR "oftan-metaoksedrin"[tw] OR optistin[tw] OR
phenoptic[tw] OR phenylefrine[tw] OR phenylephedrine[tw] OR prefrin[tw] OR "pupiletto forte"[tw] OR rectasol[tw] OR "rhinall 10"[tw]
OR "slv 325"[tw] OR slv325[tw] OR sucraphen[tw] OR vazculep[tw] OR visadron[tw] OR vistafrin[tw] OR vistosan[tw] OR "532-38-7"[tw] OR
"59-42-7"[tw] OR "61-76-7"[tw])
#25 (Pholedrine[tw] OR "4 hydroxy n methylamphetamine"[tw] OR "4 hydroxymethamphetamine"[tw] OR adyston[tw] OR "para
hydroxymethamphetamine"[tw] OR "p-hydroxymethamphetamine"[tw] OR paredrinol[tw] OR "Pholedrin liquidum"[tw] OR "Pholedrin-
longo-Isis"[tw] OR pulsotyl[tw] OR venosan[tw] OR veritol[tw] OR "370-14-9"[tw])
#26 (p-Hydroxyamphetamine[tw] OR "1 para hydroxyphenyl 2 propylamine"[tw] OR "alpha methyl para tyramine"[tw] OR "alpha
methyl tyramine"[tw] OR "dl 1 p hydroxyphenyl 2 propylamine"[tw] OR "dl 1 para hydroxyphenyl 2 propylamine"[tw] OR "dl
p hydroxy alpha methylphenethylamine"[tw] OR "dl para hydroxy alpha methylphenethylamine"[tw] OR "h 66 37"[tw] OR "para
hydroxy alpha methylphenethylamine"[tw] OR Hydroxyamfetamine[tw] OR Hydroxyamphetamin[tw] OR Hydroxyamphetamine[tw] OR
Hydroxyphenylisopropylamine[tw] OR Methyltyramine[tw] OR Norpholedrin[tw] OR norpholedrine[tw] OR oxamphetamine[tw] OR
Oxyamphetamine[tw] OR paradrine[tw] OR parahydroxyamphetamine[tw] OR Paredrine[tw] OR paredrinea[tw] OR paredrinex[tw] OR
pedrolone[tw] OR pulsoton[tw] OR "103-86-6"[tw] OR "1518-86-1"[tw] OR "306-21-8"[tw])
#27 (Racepinephrine[tw] OR Micronefrin[tw] OR micronefrine[tw] OR Micronephrine[tw] OR mikronephrin[tw] OR racadrenalin[tw] OR
"Racepinefrine Hydrochloride"[tw] OR racinephrine[tw] OR Vaponefrin[tw] OR vaponefrine[tw] OR vaponephrin[tw] OR "329-65-7"[tw])
#28 (Scopolamine[tw] OR "Boro Scopol"[tw] OR BoroScopol[tw] OR Hyoscine[tw] OR Kwells[tw] OR "levo hyoscinehydrobromide"[tw] OR
Scoburen[tw] OR Scopace[tw] OR scopos[tw] OR "Travacalm HO"[tw] OR Vorigeno[tw] OR "114-49-8"[tw] OR atrochin[tw] OR atroquin[tw]
OR atroscine[tw] OR hyosceine[tw] OR hysco[tw] OR "l epoxytropine tropate"[tw] OR "n methylhyoscine"[tw] OR oscine[tw] OR
scopalamine[tw] OR "scopine tropate"[tw] OR scopolamin[tw] OR transcop[tw] OR "tropic acid ester with scopine"[tw] OR "138-12-5"[tw]
OR "51-34-3"[tw] OR "55-16-3"[tw])
#29 (Tropicamide[tw] OR "alcon-mydril"[tw] OR bistropamide[tw] OR "cendo mydriatyl"[tw] OR "Colircusi Tropicamida"[tw] OR
midriaticum[tw] OR mydiacyl[tw] OR mydral[tw] OR mydramide[tw] OR mydriacyl[tw] OR Mydriafair[tw] OR Mydriaticum[tw] OR
"mydrin m"[tw] OR "mydrin p"[tw] OR Mydrum[tw] OR "n ethyl 2 phenyl n pyrid 4 ylmethylhydracrylamide"[tw] OR "n ethyl n 4
picolyltropamide"[tw] OR "n ethyl n gamma picolyltropamide"[tw] OR "n ethyl n pyrid 4 ylmethyltropamide"[tw] OR "Ocu-Tropic"[tw] OR
OcuTropic[tw] OR opticyl[tw] OR sandol[tw] OR sintropic[tw] OR "tropamid forte"[tw] OR "tropic acid n ethyl n gamma picolyl amide"[tw]
OR Tropicacyl[tw] OR tropicamid[tw] OR "tropico eye"[tw] OR tropicol[tw] OR tropikamid[tw] OR tropimil[tw] OR visumidriatic[tw] OR
"1508-75-4"[tw])
#30 (Tyramine[tw] OR "4 hydroxyphenethylamine"[tw] OR lyramine[tw] OR mydrial[tw] OR "para hydroxyphenethylamine"[tw] OR
paratyramine[tw] OR systogene[tw] OR tiramine[tw] OR tocosine[tw] OR tyramin[tw] OR tyrosamine[tw] OR uteramine[tw] OR
"51-67-2"[tw] OR "60-19-5"[tw])
#31 (Vibrocil[tw] OR "8059-14-1"[tw])
#32 (Yohimbine[tw] OR actibine[tw] OR aphrodine[tw] OR aphrodyne[tw] OR Corynanthine[tw] OR "corynine hydrochloride"[tw] OR
"dayto-himbin"[tw] OR "methyl yohimbine 16alpha carboxylate"[tw] OR "methylyohimbane 16alpha carboxylate"[tw] OR Pluriviron[tw]
OR quebrachin[tw] OR "quebrachine hydrochloride"[tw] OR Rauhimbine[tw] OR Rauwolscine[tw] OR urobine[tw] OR yobin[tw] OR
yobinol[tw] OR yocan[tw] OR yocaral[tw] OR Yocon[tw] OR yocon[tw] OR yohimbe[tw] OR "yohimbic acid methyl ester"[tw] OR
yohimbin[tw] OR Yohimex[tw] OR yohimex[tw] OR yohimibin[tw] OR yovital[tw] OR "146-48-5"[tw] OR "65-19-0"[tw])
#33 #9 OR #10 OR #11 OR #12 OR #13 OR #14 OR #15 OR #16 OR #17 OR #18 OR #19 OR #20 OR #21 OR #22 OR #23 OR #24 OR #25 OR #26
OR #27 OR #28 OR #29 OR #30 OR #31 OR #32
#34 #8 AND #33
#35 #1 AND #34
Informed decisions.
#36 Medline[sb]
#37 #35 NOT #36
Appendix 6. ClinicalTrials.gov search strategy

(uveitis OR iridocyclitis OR iritis OR iritides OR cyclitis OR scleritis) AND (mydriatics OR atropine OR berefrine OR cyclopentolate OR
epinephrine OR ethylmorphine OR eucatropine OR homatropine OR hyoscyamine OR ibopamine OR oxyphenonium)
(uveitis OR iridocyclitis OR iritis OR iritides OR cyclitis OR scleritis) AND (methylatropine OR naphazoline OR oxedrine OR p-
hydroxyamphetamine OR phenylephrine OR pholedrine OR scopolamine OR tropicamide OR tyramine OR vibrocil OR yohimbine)
Appendix 7. WHO ICTRP search strategy

uveitis AND mydriatics OR uveitis AND cycloplegics OR uveitis AND atropine OR uveitis AND berefrine OR uveitis AND cyclopentolate
OR uveitis AND epinephrine OR uveitis AND ethylmorphine OR uveitis AND eucatropine OR uveitis AND homatropine OR uveitis AND
hyoscyamine OR uveitis AND ibopamine OR uveitis AND oxyphenonium OR uveitis AND methylatropine OR uveitis AND naphazoline OR
uveitis AND oxedrine OR uveitis AND p-hydroxyamphetamine OR uveitis AND phenylephrine OR uveitis AND pholedrine OR uveitis AND
racepinephrine OR uveitis AND scopolamine OR uveitis AND tropicamide OR uveitis AND tyramine OR uveitis AND vibrocil OR uveitis AND
yohimbine
iridocyclitis AND mydriatics OR iridocyclitis AND cycloplegics OR iridocyclitis AND atropine OR iridocyclitis AND berefrine OR iridocyclitis
AND cyclopentolate OR iridocyclitis AND epinephrine OR iridocyclitis AND ethylmorphine OR iridocyclitis AND eucatropine OR iridocyclitis
AND homatropine OR iridocyclitis AND hyoscyamine OR iridocyclitis AND ibopamine OR iridocyclitis AND oxyphenonium OR iridocyclitis
AND methylatropine OR iridocyclitis AND naphazoline OR iridocyclitis AND oxedrine OR iridocyclitis AND p-hydroxyamphetamine OR
iridocyclitis AND phenylephrine OR iridocyclitis AND pholedrine OR iridocyclitis AND racepinephrine OR iridocyclitis AND scopolamine OR
iridocyclitis AND tropicamide OR iridocyclitis AND tyramine OR iridocyclitis AND vibrocil OR iridocyclitis AND yohimbine
iritis AND mydriatics OR iritis AND cycloplegics OR iritis AND atropine OR iritis AND berefrine OR iritis AND cyclopentolate OR iritis AND
epinephrine OR iritis AND ethylmorphine OR iritis AND eucatropine OR iritis AND homatropine OR iritis AND hyoscyamine OR iritis AND
ibopamine OR iritis AND oxyphenonium OR iritis AND methylatropine OR iritis AND naphazoline OR iritis AND oxedrine OR iritis AND p-
hydroxyamphetamine OR iritis AND phenylephrine OR iritis AND pholedrine OR iritis AND racepinephrine OR iritis AND scopolamine OR
iritis AND tropicamide OR iritis AND tyramine OR iritis AND vibrocil OR iritis AND yohimbine
iritides AND mydriatics OR iritides AND cycloplegics OR iritides AND atropine OR iritides AND berefrine OR iritides AND cyclopentolate
OR iritides AND epinephrine OR iritides AND ethylmorphine OR iritides AND eucatropine OR iritides AND homatropine OR iritides AND
hyoscyamine OR iritides AND ibopamine OR iritides AND oxyphenonium OR iritides AND methylatropine OR iritides AND naphazoline OR
iritides AND oxedrine OR iritides AND p-hydroxyamphetamine OR iritides AND phenylephrine OR iritides AND pholedrine OR iritides AND
racepinephrine OR iritides AND scopolamine OR iritides AND tropicamide OR iritides AND tyramine OR iritides AND vibrocil OR iritides AND
yohimbine
cyclitis AND mydriatics OR cyclitis AND cycloplegics OR cyclitis AND atropine OR cyclitis AND berefrine OR cyclitis AND cyclopentolate
OR cyclitis AND epinephrine OR cyclitis AND ethylmorphine OR cyclitis AND eucatropine OR cyclitis AND homatropine OR cyclitis AND
hyoscyamine OR cyclitis AND ibopamine OR cyclitis AND oxyphenonium OR cyclitis AND methylatropine OR cyclitis AND naphazoline OR
cyclitis AND oxedrine OR cyclitis AND p-hydroxyamphetamine OR cyclitis AND phenylephrine OR cyclitis AND pholedrine OR cyclitis AND
racepinephrine OR cyclitis AND scopolamine OR cyclitis AND tropicamide OR cyclitis AND tyramine OR cyclitis AND vibrocil OR cyclitis AND
yohimbine
scleritis AND mydriatics OR scleritis AND cycloplegics OR scleritis AND atropine OR scleritis AND berefrine OR scleritis AND cyclopentolate
OR scleritis AND epinephrine OR scleritis AND ethylmorphine OR scleritis AND eucatropine OR scleritis AND homatropine OR scleritis AND
hyoscyamine OR scleritis AND ibopamine OR scleritis AND oxyphenonium OR scleritis AND methylatropine OR scleritis AND naphazoline
OR scleritis AND oxedrine OR scleritis AND p-hydroxyamphetamine OR scleritis AND phenylephrine OR scleritis AND pholedrine OR scleritis
AND racepinephrine OR scleritis AND scopolamine OR scleritis AND tropicamide OR scleritis AND tyramine OR scleritis AND vibrocil OR
scleritis AND yohimbine
Appendix 8. Data on study characteristics
Mandatory items Optional items
Methods
Study design • Parallel-group randomized controlled trial (RCT) i.e. people randomized to • Exclusions after ran-
treatment domization

Informed decisions.
(Continued)
• Within-person RCT i.e. eyes randomized to treatment • Losses to follow-up
• Cluster-RCT i.e. communities randomized to treatment • Number random-
• Cross-over RCT ized/analyzed
• Other, specify • How were missing da-
ta handled? e.g. avail-
Eyes or • One eye included in study, specify how eye selected able case analysis, im-
putation methods
• Two eyes included in study, both eyes received same treatment, briefly
Unit of randomization/ specify how analyzed (best/worst/average/both and adjusted for within- • Reported power cal-
unit of analysis person correlation/both and not adjusted for within person correlation) culation (Y/N), if yes,
and specify if mixture of one eye and two eyes sample size and power
• Two eyes included in study, eyes received different treatments, specify if • Unusual study de-
correct pair-matched analysis done sign/issues
Participants
Country • Setting
• Ethnic group
Total number of partici- This information should be collected for total study population recruited in- • Equivalence of base-
pants to the study. If these data are reported only for the people who were followed line characteristics (Y/
up, please indicate N)
Number (%) of men and
women
Average age and age

range
Inclusion criteria
Exclusion criteria
Interventions
Intervention (n = ) • Number of people randomized to this group

• Drug (or intervention) name
Comparator (n = )
• Dose
• Frequency
• Route of administration
Outcomes
Primary and secondary • List outcomes Planned/actual length of

outcomes, as defined in • Adverse events reported (Y/N) follow-up
study reports • Length of follow-up and intervals at which outcomes assessed
HISTORY
Protocol first published: Issue 3, 2019
Review first published: Issue 8, 2020
CONTRIBUTIONS OF AUTHORS
JH: conception and design of study, drafting the review, final approval of the document published.
SS: design of study, drafting the review, final approval of the document published.
MK; CM; SA; QN: design of study, commenting on the review, final approval of the document published.

Informed decisions.
DECLARATIONS OF INTEREST
JH: none known.
SS: none known.
MK: none known.
CM: none known.
SA: none known.
QN: has received grants and other financial support from Genentech, Regeneron, AbbVie, Psivida, XOMA, Santen, Allergan, and Heidelberg.
However, none of these are relevant to the current Cochrane Review.
SOURCES OF SUPPORT
Internal sources
• None, Other
External sources
• Methodological support provided by the Cochrane Eyes and Vision (CEV) US Project, supported by grant 5 UG1 EY020522, National Eye
Institute, National Institutes of Health, USA
• National Institute for Health Research (NIHR), UK
* Richard Wormald, Co-ordinating Editor for CEV acknowledges financial support for his CEV research sessions from the Department
of Health through the award made by the NIHR to Moorfields Eye Hospital NHS Foundation Trust and University College London
Institute of Ophthalmology for a Specialist Biomedical Research Centre for Ophthalmology.
* This review was supported by the NIHR, via Cochrane Infrastructure funding to the CEV UK editorial base.
The views expressed in this publication are those of the authors and not necessarily those of the NIHR, NHS, or the Department of Health.
DIFFERENCES BETWEEN PROTOCOL AND REVIEW

The title of the review has been amended from Topical mydriatics as adjunctive therapy for traumatic iridocyclitis and iritis to Topical
mydriatics as adjunctive therapy for traumatic iridocyclitis.
One new author Samuel A Abariga joined the review team.


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Cochrane

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis

Hom J, Sarwar S, Kaleem MA, Messina CR, Abariga SA, Nguyen QD

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review)

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) i

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis

Contact address: Jeffrey Hom, [email protected], [email protected].

Editorial group: Cochrane Eyes and Vision Group.

Data collection and analysis

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 1

PLAIN LANGUAGE SUMMARY

Why this question is important

How we searched for evidence

• studies on people of all ages with traumatic iridocyclitis;

How up-to-date is this review?

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 2

BACKGROUND Presentation and diagnosis

Eye injuries can lead to significant changes in an individual's life, in

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 3

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 4

Figure 1. Study flow diagram.

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 5

Data extraction and management Unit of analysis issues

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 6

• Proportion of participants with resolution of signs and Summary of main results

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 7

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 8

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 9

5.1.0 (updated March 2011). The Cochrane Collaboration, 2011.

Characteristics of excluded studies [ordered by study ID]

Study Reason for exclusion

Dunne 1979 Not the population of interest

Islam 2010 Not an RCT

Melton 1991 Not an RCT

RCT = randomized controlled trial

Appendix 1. CENTRAL search strategy

or "isopto epinal" or levoadrenalin or levoadrenaline or levoepinephrine or levorenin or levorenine or methylaminoethanolcatechol

Appendix 2. MEDLINE Ovid search strategy

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 12

33. ("51-43-4" or "55-31-2" or "6912-68-1").rn.

Appendix 3. Embase.com search strategy

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 14

#31 #30 NOT (#11 OR #23)

Appendix 4. CINAHL search strategy

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 16

S13 TI (berefrine or POPD or "105567-83-7") OR AB (berefrine or POPD or "105567-83-7")

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 17

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 18

Appendix 5. PubMed search strategy

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 19

#20 (Methylatropine[tw] OR "8-methylatropinium nitrate"[tw] OR "31610-87-4"[tw])

Appendix 6. ClinicalTrials.gov search strategy

Appendix 7. WHO ICTRP search strategy

Appendix 8. Data on study characteristics

Mandatory items Optional items

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 21

Average age and age

Intervention (n = ) • Number of people randomized to this group

Primary and secondary • List outcomes Planned/actual length of

Topical mydriatics as adjunctive therapy for traumatic iridocyclitis (Review) 22