Pediatric Distress from Cyclopentolate: Can a Better Drop Be Formulated?

Abstract

Cyclopentolate, a commonly used cycloplegic/mydriatic agent in pediatric ophthalmologic practice, causes a brief but intense stinging sensation of the eye. The consequent distress to the child adds to the difficulty of applying additional drops and can adversely affect the child's cooperation for the remainder of the examination. A drop with the desirable properties of cyclopentolate but which caused less discomfort would be of great benefit. We compared cyclopentolate 1.0% against cyclopentolate 1.0% with proparacaine 0.25% in a double-masked fashion in children and adults. Adults and children age 5 to 15 years both preferred the combination drop by greater than 2:1 (p <0.05). Among younger children, an observational scale of distress showed no significant difference in overall distress between the two drops when they were administered only once. When two sets of drops were administered during a 5-minute period, however, the children tended to show less distress to a second set of cyclopentolate/proparacaine than to a second set of cyclopentolate alone.

• cyclopentolate
• proparacaine
• cycloplegia
• eye examination