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Time of maximum cycloplegia after instillation of cyclopentolate 1% in children with brown irises
Sittikorn Laojaroenwanit1, Vimontip Layanun1, Pokpong Praneeprachachon1
1Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Insights
Maximum cycloplegia in children with brown irises occurs 30 minutes after the first cyclopentolate drop. Pupillary reaction is not a reliable indicator of maximum cycloplegia.
Area of Science:
- Ophthalmology
- Pediatric Eye Care
- Pharmacology
Background:
- Accurate refractive error assessment in children is crucial for timely intervention.
- Cyclopentolate is a commonly used cycloplegic agent in pediatric eye examinations.
- Understanding the onset of maximum cycloplegia is essential for optimizing examination protocols.
Purpose of the Study:
- To determine the time to maximum cycloplegia after cyclopentolate 1% instillation in children with brown irises.
- To assess the correlation between pupillary reaction and the time of maximum cycloplegia.
- To identify any adverse effects associated with cyclopentolate use.
Main Methods:
- Prospective analytical study of children aged 5-14 years undergoing refraction.
- Cyclopentolate 1% instilled three times at 10-minute intervals.
- Spherical equivalent, pupillary reaction, and diameter recorded pre-instillation and at nine intervals post-instillation.
Main Results:
- Maximum cycloplegia was achieved at 30 minutes post-first instillation in most children.
- A weak correlation (r=-0.07) was found between pupillary reaction and time to maximum cycloplegia.
- No significant side effects were reported during the study period.
Conclusions:
- The onset of maximum cycloplegia following cyclopentolate 1% in children with brown irises is approximately 30 minutes after the initial dose.
- Pupillary response is an unreliable indicator for determining the peak effect of cyclopentolate.
- Cyclopentolate 1% appears safe for use in this pediatric population.
Purpose:
We aimed to 1) determine the time of maximum cycloplegia after instillation of cyclopentolate 1% in children with brown irises, 2) evaluate the correlation between the pupillary reaction and time of maximum cycloplegia, and 3) identify any side effects of the medication.
Patients And Methods:
This was a prospective analytical study involving children aged 5 to 14 years who were attending refraction clinic. Cyclopentolate 1% was instilled three times at 10-minute intervals. The spherical equivalent, pupillary reaction, and pupillary diameter were recorded before the first drop and nine times after the last drop at 10-minute intervals. Side effects were assessed. Time of maximum cycloplegia was determined from the time point at which the 95% confidence interval of the differences between the mean spherical equivalent at each point and its final value at 110 minutes was reached and remained within the equivalence limit (±0.25 D).
Results:
Sixty children were enrolled in this study. Their mean age was 9.8 years (range: 5-4 years). Time of maximum cycloplegia was reached at 30 minutes after the first instillation of cyclopentolate. A poor correlation was observed between the pupillary reaction and the time of maximum cycloplegia (r=-0.07). The mean pupillary diameter at 30 minutes was 3.7±1.3 mm, and further dilation occurred thereafter. No side effects were observed.
Conclusion:
In most children, maximum cycloplegia was reached 30 minutes after the first instillation of cyclopentolate. The absence of a pupillary reaction should not be used as an indicator of maximum cycloplegia.
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