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Comparison of cycloplegia with atropine 1% versus cyclopentolate 1

Ram P Singh1, Abadan K Amitava, Nikita Sharma

  • 1Institute of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Indian Journal of Ophthalmology
|November 22, 2023
PubMed

Insights

Cyclopentolate 1% effectively induces cycloplegia in children, comparable to atropine 1%. Cyclopentolate is recommended for busy clinics due to its rapid action and short duration.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry

Background:

  • Cycloplegic refraction is essential for determining children's accurate refractive status.
  • Comparing the efficacy of different cycloplegic agents is crucial for clinical practice.

Purpose of the Study:

  • To compare the cycloplegia induced by cyclopentolate 1% versus atropine 1% in children using retinoscopy.

Main Methods:

  • A parallel-designed interventional study included 67 children (4-17 years).
  • Cycloplegic refraction was performed using cyclopentolate 1% and atropine 1% ointment.
  • Spherical equivalents (SEs) were averaged and compared using paired t-test and Bland-Altman analysis.

Main Results:

  • Atropine induced a mean SE of +1.93 ± 2.0 D, while cyclopentolate induced +1.75 ± 1.95 D.
  • Atropine achieved slightly greater cycloplegia by 0.18 D (P=0.002).
  • Both methods showed strong correlation (r=0.975) and acceptable agreement (Bland-Altman limits: 1.06 to -0.71 D).

Conclusions:

  • Cyclopentolate 1% is largely as effective as atropine 1% for inducing cycloplegia in children.
  • Atropine may be preferred for children under 15 with hyperopia >5.0 D.
  • Cyclopentolate is a suitable first-line cycloplegic in high-volume clinics due to its rapid onset and short duration.
Abstract

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