Related Experiment Video
Updated: Mar 12, 2026
Ultrasound Cyclo Plasty in Eyes with Glaucoma
Published on: January 26, 2018
A Clinical Randomized Trial Comparing the Cycloplegic Effect of Cyclopentolate Drops Applied to Closed Eyelids Versus
Jocelyn Zurevinsky1, Kallie Sawchuk1, Hyun J Lim2
1From the Orthoptic Clinic, Eye Care Centre, Saskatoon Health Region, Saskatoon, Saskatchewan.
Insights
Instilling cyclopentolate eye drops on closed eyelids achieved complete cycloplegia in children as effectively as direct instillation. This method offers a less traumatic approach for pediatric eye exams, improving the refraction and fundus examination experience.
Area of Science:
- Ophthalmology
- Pediatric Eye Care
- Pharmacology
Background:
- Pediatric eye exams require adequate cycloplegia and dilation.
- Traditional methods of drop instillation can be traumatic for children.
- Alternative, less invasive instillation techniques are needed.
Purpose of the Study:
- To evaluate the efficacy of cyclopentolate hydrochloride 1% instillation on closed eyelids for achieving cycloplegia in children.
- To compare this method with traditional direct instillation onto the conjunctiva.
Main Methods:
- Ninety pediatric patients undergoing annual refraction were enrolled.
- One drop of cyclopentolate hydrochloride 1% was applied to each eye.
- Drops were instilled on the closed eyelid's inner canthus (indirect) and directly onto the fellow eye's conjunctiva (direct).
Main Results:
- 83% of eyes achieved full cycloplegia with a single drop.
- Both indirect (closed eyelid) and direct instillation methods showed comparable success rates.
- Patient factors like age, eye color, and refractive error did not significantly impact success rates.
Conclusions:
- Instilling cyclopentolate hydrochloride 1% on closed eyelids is an effective alternative for achieving cycloplegia.
- This method demonstrates equivalent efficacy to direct instillation.
- Closed-lid instillation may reduce patient discomfort during pediatric eye examinations.
Background And Purpose:
Adequate cycloplegia and dilation are required for refraction and fundus exam in children. Standard practice is to instill cycloplegic drops in the inferior cul-de-sac, and this is often traumatic for children. Our study assesses the use of cyclopentolate on closed lids as a method of instillation for ensuring complete cycloplegia.
Patients And Method:
Ninety children presenting for annual refraction were enrolled. Three were excluded as they did not finish the testing. One drop of Alcaine® and one drop of cyclopentolate HCL 1% were used in each eye. Cyclopentolate drops were placed on the inner canthus near the lid margin on the closed eye and directly onto the conjunctiva of the fellow eye.
Results:
Overall, 145/174 eyes (83%) were fully cyclopleged with one drop. The methods of instillation were equally successful (seventy-two indirect vs. seventy-three direct). Age, eye color, spherical refractive error, astigmatic refractive error, and presence of amblyopia on the study visit played no role in the success of either method. Dark irises where the pupil margin was clinically indistinguishable had the largest number of failures (n = 17/44) in comparison to light irises (12/130), but had an equal amount of failures for both direct and indirect methods.
Conclusion:
Placing one drop of cyclopentolate HCL 1% on a closed eyelid had a success rate for complete cycloplegia that was equivalent to placing one drop directly on the cornea.
Related Concept Videos
01:23Ophthalmic Drug Delivery Systems
01:27Open Angle Glaucoma: Treatment
Drugs such as carbonic anhydrase inhibitors, α2- and...
01:28Angle Closure Glaucoma: Treatment