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Introduction: First responders and those who work with organophosphate (OP) compounds can experience ocular symptoms similar to those caused by exposure to low levels of nerve agents. This study was designed to examine the efficacy of a safe, clinically available, simulant that reproduces ocular symptoms associated with low-level OP exposure. Among these ocular symptoms are a constriction of the pupils (miosis), decreased visual acuity, and changes in accommodation., Materials and Methods: Volunteers aged 18-40 were assigned to groups receiving either a two-drop or three-drop dose of FDA approved 2% pilocarpine ophthalmic solution. Baseline visual performance measurements were taken before eye drop instillation and a timer was started following the first drop of pilocarpine. Once eye drops were administered, visual performance including distant and near vision, pupil size, and accommodation were measured every 5 minutes for 2 hours., Results: Both groups experienced significant miosis in excess of 90 minutes. Visual acuity was significantly reduced because of accommodative changes. The three-drop group experienced longer lasting combined effects when compared to the two-drop group., Conclusions: 2% pilocarpine ophthalmic solution can safely simulate major ocular symptoms of OP exposure for behavioral research studies for at least 60 minutes., (© Association of Military Surgeons of the United States 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Changes in electrodermal activity (EDA) correlate with arousal and stress during stimulating experiences. We hypothesized that associations exist between short-term performance gains and changes in EDA. A total of 187 combat medics were randomly assigned to simulation (S), live tissue (L), or video (V) based training in the recognition and treatment of nerve agent casualties. Change in EDA from baseline to training was quantified for tonic and phasic responses and was categorized as positive (>+10%), no change (±10%), or negative (<-10%). Cognitive and psychomotor skills assessments were applied before and after the baseline/training period to quantify short-term performance changes. Statistically significant differences in both EDA arousal measures between training modalities (p < 0.001 with L > S ∼ V) were observed. Notably, larger proportions of trainees experienced negative changes in tonic (67%) and phasic (21%) EDA measures in the V group when compared to the L and S groups. Regardless of training modality, negative tonic and phasic EDA responses were associated with lower psychomotor performance gains and this finding approached statistical significance (tonic: p = 0.056, phasic: p = 0.08). No significant differences were noted in pre- to post-training cognitive performance between EDA response categories. As quantified by EDA response to training, reduced arousal was associated with lower short-term psychomotor, but not cognitive, performance gains., (Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.)