Paediatric cycloplegia: a new approach

Eye
P ShahG G Adams

Abstract

Cycloplegia is a traumatic experience for most children, as guttae cyclopentolate stings on instillation into the conjunctival sac. This may result in inadequate cycloplegia, difficulty in further examination and a child who is scared of both the doctor and the ophthalmology department. Guttae proxymetacaine hydrochloride 0.5% (Ophthaine, Proparacaine) is a topical local anaesthetic that does not sting on instillation. Eighty-eight consecutive children in the paediatric clinic were assessed. The response of the patient to previous use of cyclopentolate alone was assessed by the parents of the child using a grading scheme. The use of proxymetacaine prior to instillation of cyclopentolate was then assessed using the same grading system. Seventy per cent of the children who received cyclopentolate alone were assessed to have cried and been unhappy. Ninety-one per cent of the children who received cyclopentolate after proxymetacaine were assessed to have shown no adverse reaction to the cycloplegia and remained happy. This study shows that use of proxymetacaine prior to cyclopentolate results in atraumatic cycloplegia in children. This can confer multiple benefits on the doctor-patient relationship.

References

Jan 1, 1989·International Ophthalmology Clinics·G O Rosenwasser
Nov 1, 1953·American Journal of Ophthalmology·C W BOOZAN, I J COHEN
Sep 1, 1961·Archives of Ophthalmology·B C GETTES, O BELMONT

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Citations

Mar 15, 2003·Optometry and Vision Science : Official Publication of the American Academy of Optometry·Karla ZadnikUNKNOWN Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study Group
May 2, 2007·Ophthalmic & Physiological Optics : the Journal of the British College of Ophthalmic Opticians (Optometrists)·David E HaddadDavid M Krumholz
Nov 18, 2014·Journal of Pediatric Ophthalmology and Strabismus·Emre GülerMehmet Balci
Aug 25, 2015·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Jane Lim SujuanAudrey Chia
Aug 7, 2019·Asia-Pacific Journal of Ophthalmology·Jane LimSwati Handa

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