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The cycloplegic effects of cyclopentolate and tropicamide on myopic children
1Department of Ophthalmology, National Taiwan University, Taipei, Republic of China.
Insights
For myopic children, 1% tropicamide offers a faster cycloplegic effect than cyclopentolate for refractive checks. Tropicamide is recommended for routine examinations due to its rapid onset and sufficient efficacy.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Accurate refractive error assessment is crucial for managing myopia in children.
- Cycloplegic agents are used to relax accommodation for precise refraction.
- Comparing the efficacy and onset of action of different cycloplegic agents is important for clinical practice.
Purpose of the Study:
- To evaluate and compare the time course and maximal cycloplegic effect of 1% cyclopentolate and 1% tropicamide in myopic children.
- To determine if cyclopentolate offers a superior cycloplegic effect compared to tropicamide.
- To assess the suitability of tropicamide for routine refractive status checking in pediatric myopia.
Main Methods:
- A comparative study involving 52 myopic children.
- Administration of 1% cyclopentolate or 1% tropicamide via eyedrops.
- Cycloplegic refraction measured using an auto-refractometer at regular intervals (every 15 min for 90 min).
- Sequential drug administration in a subset of participants to compare efficacy.
Main Results:
- Tropicamide demonstrated a faster onset of cycloplegic effect (around 30 min) compared to cyclopentolate (around 45 min).
- Both agents showed stable cycloplegic effects within the 90-minute observation period.
- The additional cycloplegic effect of cyclopentolate over tropicamide was minimal (-0.1D).
- Neither agent significantly affected corneal power or refractive astigmatism, although astigmatism showed variability with cyclopentolate.
Conclusions:
- 1% Tropicamide is a suitable and effective agent for routine refractive status checking in myopic children due to its rapid onset.
- Cyclopentolate's effect is slower, and its added benefit over tropicamide is negligible for this purpose.
- Tropicamide provides a practical alternative for pediatric eye examinations requiring cycloplegia.
Abstract:
Thirty-seven myopic children were given either 1-2 drops of 1% cyclopentolate or 1% tropicamide twice with 5 min intervals to evaluate the time course and maximal cycloplegic effect of both agents. The other fifteen subjects were given 1% tropicamide initially, then 1% cyclopentolate given after 30 min of maximal effect of tropicamide appeared to evaluate whether the effect of cyclopentolate was superior to tropicamide. Cycloplegic refraction was measured with an auto-refractometer (Topcon RK-3000) before drug delivery and every 15 min thereafter, for 90 min. The maximal cycloplegic effect of cyclopentolate was around 45 min, then it remained stable until 90 min after the last instillation. The effect of tropicamide was faster than that of cyclopentolate. It was around 30 min, then it stabilized until 75 min. The extra effect of cyclopentolate over tropicamide was minimal (only -0.1D). The power of cornea and astigmatism were not affected by either agent. However, a big variation in astigmatism was noted during the course, especially with cyclopentolate. This study suggests that 1% tropicamide should be a good agent for routine refractive status checking on myopic children.