The Use of Oral Midazolam to Facilitate the Ophthalmic Examination of Children with Autism and Developmental Disorders.
One drink of midazolam lets you finish eye exams in almost every autistic child who cannot stay awake and calm.
01Research in Context
What this study did
Doctors gave one dose of liquid midazolam to children with autism or developmental delay.
The kids needed eye exams that they could not sit through while awake.
The team then watched how many exams were finished and if any problems happened.
What they found
The drug let doctors finish the eye exam in almost every child.
No child had a bad reaction and everyone went home soon after.
How this fits with other research
McConnell et al. (2020) got autistic young men through dental exams with no drugs at all. They used small steps and stopped giving breaks when the men yelled or hit.
The two studies seem to clash: one uses pills, one uses practice. The gap is the child’s starting point. McConnell’s clients could learn with rewards and limits. R et al.’s group could not stay still even with coaching, so light sedation was the safer path.
Li et al. (2019) also gave midazolam, but stuck it inside the cheek along with a nose spray. They saw the same good result for brain scans, showing the medicine works across different body sites and tests.
Why it matters
You now have a quick tool for kids who simply cannot hold their gaze or stay seated for vision tests. Ask the nurse for 0.5 mg/kg liquid midazolam, max 15 mg, give it thirty minutes before the exam, and you can get the data you need to rule out sight problems that may feed problem behavior.
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02At a glance
03Original abstract
Ophthalmic examinations of developmentally delayed/autistic children are challenging. Oral midazolam may be a viable alternative to general anaesthesia for this indication. Single-centre retrospective cohort study (January 2018-March 2020). Oral midazolam (0.5 mg/kg, max 15 mg). Metrics included: patient demographics, examination completion rate, duration of stay and adverse events. 50 oral midazolam examinations were performed (45 patients). Mean age was 79.12 months. All had developmental delay (66.67% autism). Time to ophthalmic examination was 60.31 minutes. Eye examination was successfully completed in 98%. No adverse events were reported. Mean stay was 3.35 hours. Oral midazolam (0.5 mg/kg, max 15 mg) is associated with safe, successful completion of ophthalmic examinations in children previously unexaminable in clinic.
Journal of autism and developmental disorders, 2021 · doi:10.1371/journal.pone.0213074