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Efficacy of a Cycloplegic Agent Administered as a Spray in the Pediatric Population

Aldo Vagge, Chiara Del Noce, Marco Pellegrini

    Journal of Pediatric Ophthalmology and Strabismus
    |September 21, 2020
    PubMed

    Insights

    Cyclopentolate 1% spray reduced distress in pediatric patients compared to drops, but may be less effective for cycloplegia in children with dark irises.

    Area of Science:

    • Ophthalmology
    • Pediatric Medicine
    • Pharmacology

    Background:

    • Accurate refractive error assessment in young children is crucial for timely intervention.
    • Traditional methods of administering cycloplegic eye drops can cause distress in pediatric patients.
    • Cyclopentolate 1% is a commonly used anticholinergic agent for inducing cycloplegia.

    Purpose of the Study:

    • To assess the efficacy and tolerability of cyclopentolate 1% delivered as a spray versus traditional drops in children aged 3-6 years.
    • To compare patient distress levels between the spray and drop administration methods.
    • To evaluate the adequacy of cycloplegia for refraction in both groups.

    Main Methods:

    • A prospective, randomized, parallel-group study involving healthy pediatric volunteers aged 3-6 years.
    • Participants were assigned to receive either a single drop or a single puff of cyclopentolate 1% into closed eyes.
    • Distress levels and pupil diameter were measured; cycloplegia adequacy was assessed for refraction.

    Main Results:

    • The spray group experienced significantly lower distress levels than the drop group (P < .0001), except in 6-year-olds.
    • No significant difference in pupil diameter was observed between the spray and drop groups (P = .51).
    • 16.6% of patients with dark irises in the spray group did not achieve adequate cycloplegia for accurate refraction.

    Conclusions:

    • Cyclopentolate 1% spray offers a less distressing alternative for inducing cycloplegia in uncooperative children.
    • However, reduced efficacy in achieving adequate cycloplegia for refraction in children with dark irises necessitates caution.
    • Physicians should consider iris pigmentation when choosing the administration method for cyclopentolate 1% in pediatric patients.
    Abstract

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