Cycloplegic refraction using atropine minidrops

Abstract

Topical application of atropine for cycloplegic refraction may be associated with alarming systemic reactions in infants and children. Cycloplegic refraction and pulse rate were compared after short-term minidrop application of atropine with a calibrated pipette (3 × 5 μl) and standard atropine application from commercial bottles (twice daily 30–36 μ1 for three days) in 30 hypermetropic eyes of children between 1 and 7 years of age. The mean spherical equivalents of cycloplegic refraction achieved after minidrop application was 0.23 D lower than that following standard application. In many cases, there was a substantial increase in pulse rate 90 minutes after atropine instillation, both from minidrops and from commercial bottles. Short-term minidrop application of atropine with a calibrated pipette may be used for cycloplegic refraction in infants and children if one wishes to reduce the total atropine dose.

Key Words:

• atropine
• cycloplegic refraction
• minidrops
• toxicity
• hypermetropia