{"id":6479,"date":"2021-03-29T16:29:57","date_gmt":"2021-03-29T19:29:57","guid":{"rendered":"https:\/\/phelcom.com\/?p=6479"},"modified":"2023-06-02T13:55:05","modified_gmt":"2023-06-02T16:55:05","slug":"exame-oftalmologico","status":"publish","type":"post","link":"https:\/\/phelcom.com\/pt-br\/blog\/mercado\/exame-oftalmologico\/","title":{"rendered":"Exame oftalmol\u00f3gico: midr\u00edase x n\u00e3o midri\u00e1tico. Qual escolher?"},"content":{"rendered":"

Atualmente, parte dos exames oftalmol\u00f3gicos podem ser feitos de duas maneiras: com midr\u00edase ou n\u00e3o midri\u00e1tico<\/a>.<\/p>\n

A dilata\u00e7\u00e3o da pupila ainda \u00e9 o processo mais adotado devido \u00e0 visualiza\u00e7\u00e3o completa da estrutura dos olhos. Por\u00e9m, as avalia\u00e7\u00f5es n\u00e3o midri\u00e1ticas vem ganhando cada vez mais espa\u00e7o por oferecer alta qualidade da imagem, conforto ao paciente, redu\u00e7\u00e3o de custos, aumento da produtividade e, consequentemente, maior rentabilidade ao consult\u00f3rio.<\/p>\n

Dessa forma, qual m\u00e9todo voc\u00ea deve escolher? De fato, nem todos os exames podem ser realizados sem a dilata\u00e7\u00e3o da pupila. O n\u00e3o midri\u00e1tico \u00e9 uma op\u00e7\u00e3o para retinografias e fundoscopia, por exemplo.<\/p>\n

Em seguida, veja quais s\u00e3o as vantagens da midr\u00edase e do n\u00e3o midri\u00e1tico na execu\u00e7\u00e3o do exame oftalmol\u00f3gico.<\/p>\n

Exame oftalmol\u00f3gico: midr\u00edase<\/h2>\n

Para enxergar toda a estrutura dos olhos, usamos col\u00edrios anticolin\u00e9rgicos e\/ou alfa-adren\u00e9rgicos para dilatar a pupila. O primeiro engloba a atropina, tropicamida e ciclopentolato. J\u00e1 o alfa-adren\u00e9rgico trata-se de fenilefrina. Pode-se aplic\u00e1-los separadamente ou de modo combinado.<\/p>\n

Cada col\u00edrio tem caracter\u00edsticas pr\u00f3prias, como in\u00edcio do tempo de a\u00e7\u00e3o, per\u00edodo de dura\u00e7\u00e3o, sintomas e rea\u00e7\u00f5es. Os efeitos mais comuns apresentados s\u00e3o vis\u00e3o turva, ofuscamento e sensibilidade \u00e0 luz durante a a\u00e7\u00e3o do produto.<\/p>\n

De fato, a midr\u00edase \u00e9 bastante seguro ao paciente. Por\u00e9m, em poucos casos, podem ocorrer rea\u00e7\u00f5es como alergia ao col\u00edrio, tontura ou mal-estar. E, em rar\u00edssimas situa\u00e7\u00f5es, complica\u00e7\u00f5es mais graves, como crise de glaucoma agudo, principalmente em pacientes com o \u00e2ngulo da c\u00e2mara anterior estreito, geralmente relacionado ao alto grau de miopia (a partir de seis graus).<\/p>\n

Dilatar a pupila tamb\u00e9m traz algumas desvantagens ao m\u00e9dico e paciente, ainda mais em meio \u00e0 atual pandemia. Por exemplo, menor n\u00famero de atendimento di\u00e1rio devido \u00e0 limita\u00e7\u00e3o de pessoas na sala de espera, necessidade de acompanhante e desconforto ao paciente.<\/p>\n

Col\u00edrios anticolin\u00e9rgicos<\/h3>\n

\"Dilata\u00e7\u00e3o<\/a><\/p>\n

Os col\u00edrios anticolin\u00e9rgicos realizam a dilata\u00e7\u00e3o da pupila ao relaxar os m\u00fasculos respons\u00e1veis pela contra\u00e7\u00e3o dessa estrutura. Al\u00e9m disso, tamb\u00e9m paralisam momentaneamente o reflexo da acomoda\u00e7\u00e3o.<\/p>\n

A tropicamida \u00e9 o mais utilizado em consult\u00f3rios oftalmol\u00f3gicos. Isso por causa de dois fatores: o tempo de dura\u00e7\u00e3o \u00e9 menor, entre duas e seis horas, e o in\u00edcio de a\u00e7\u00e3o \u00e9 mais r\u00e1pido, entre 10 e 20 minutos. Se combinado com fenilefrina, dilata ainda mais.<\/p>\n

J\u00e1 o ciclopentolato bloqueia a a\u00e7\u00e3o do esf\u00edncter da \u00edris e do m\u00fasculo ciliar e \u00e9 bastante eficaz no c\u00e1lculo do grau do paciente, em exames de fundo de olho e no mapeamento da retina. Tamb\u00e9m tem uso terap\u00eautico contra uve\u00edtes. Faz a dilata\u00e7\u00e3o da pupila entre 20 e 30 minutos e tem dura\u00e7\u00e3o prolongada, de 12 a 24 horas.<\/p>\n

A atropina inicia entre 20 e 30 minutos, mas a dilata\u00e7\u00e3o dura por um longo per\u00edodo. Isso porque a degrada\u00e7\u00e3o \u00e9 lenta e os efeitos, como vis\u00e3o emba\u00e7ada, podem durar de tr\u00eas a 14 dias.<\/p>\n

Desse modo, \u00e9 adotada em alguns tratamentos de estrabismo, quando provoca vis\u00e3o turva no olho em boas condi\u00e7\u00f5es para estimular o olho desviado. Outras finalidades s\u00e3o no tratamento de inflama\u00e7\u00f5es oculares e no combate \u00e0 progress\u00e3o da miopia, com aplica\u00e7\u00f5es de doses muito baixas.<\/p>\n

Col\u00edrios alfa-adren\u00e9rgicos<\/h3>\n

Os col\u00edrios alfa-adren\u00e9rgicos provocam a dilata\u00e7\u00e3o da pupila ao estimular a contra\u00e7\u00e3o dos m\u00fasculos dos olhos. Neste agente, est\u00e1 a fenilefrina, que tem a\u00e7\u00e3o direta nos receptores alfa-adren\u00e9rgicos e deixa a pupila mais dilatada em compara\u00e7\u00e3o aos col\u00edrios anticolin\u00e9rgicos. Tamb\u00e9m apresenta in\u00edcio r\u00e1pido, em torno de 10 minutos, e dura\u00e7\u00e3o entre duas e quatro horas.<\/p>\n

\u00c9 mais empregado para exames de fundo de olho ou mapeamento da retina e em cirurgias oculares, como a de catarata. Se combinado com tropicamida, dilata ainda mais.<\/p>\n

Exame oftalmol\u00f3gico: n\u00e3o-midri\u00e1tico<\/h2>\n
\"Eyer<\/a>

Smartdevice Phelcom Eyer captura imagens de fundo do olho em alta qualidade e permite envio para a plataforma on-line Eyer Cloud.<\/p><\/div>\n

Os exames n\u00e3o midri\u00e1ticos tamb\u00e9m permitem uma \u00f3tima visualiza\u00e7\u00e3o do fundo do olho, mas sem a necessidade de dilatar a pupila. Com isso, s\u00e3o mais r\u00e1pidos de fazer. S\u00e3o indicados para retinografias e fundoscopia.<\/p>\n

Desse modo, \u00e9 poss\u00edvel aumentar o n\u00famero de atendimentos di\u00e1rios, j\u00e1 que elimina o tempo de espera para o col\u00edrio agir e o tempo do exame, diminui o per\u00edodo de atendimento e a necessidade de acompanhante para o paciente.<\/p>\n

Sem falar no maior conforto do paciente por n\u00e3o dilatar a pupila, passar menos tempo no consult\u00f3rio e precisar arranjar companhia – ainda mais com a atual pandemia.<\/p>\n

Outra vantagem do exame oftalmol\u00f3gico n\u00e3o midri\u00e1tico \u00e9 reduzir custos com col\u00edrios anest\u00e9sicos no consult\u00f3rio, que \u00e9 mais caro em rela\u00e7\u00e3o ao produto sem anest\u00e9sico.<\/p>\n

A retirada da midr\u00edase de alguns exames tamb\u00e9m elimina o risco de complica\u00e7\u00f5es, mesmo sendo rar\u00edssimas.<\/p>\n

Por fim, voc\u00ea pode optar por equipamentos n\u00e3o midri\u00e1ticos, port\u00e1teis<\/a> ou de mesa, que oferecem ainda mais nitidez nas fotografias de fundo do olho. Al\u00e9m disso, h\u00e1 op\u00e7\u00f5es conectadas \u00e0 nuvem<\/a>, que permitem o diagn\u00f3stico remoto, e com \u00f3timo custo-benef\u00edcio.<\/p>\n

Com informa\u00e7\u00f5es do artigo \u201cCol\u00edrios Anticolin\u00e9rgicos ou alfa-adren\u00e9rgicos<\/a>\u201d, do oftalmologista Pedro Paulo Cabral.<\/p>\n

Acompanhe o blog da Phelcom e fique por dentro das principais novidades em sa\u00fade dos olhos.<\/p>\n","protected":false},"excerpt":{"rendered":"

Saiba quais s\u00e3o as vantagens de cada m\u00e9todo. <\/p>\n","protected":false},"author":3,"featured_media":5878,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_et_pb_use_builder":"","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[105],"tags":[],"class_list":["post-6479","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-mercado"],"acf":[],"yoast_head":"\nExame oftalmol\u00f3gico: midr\u00edase x n\u00e3o midri\u00e1tico. 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