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PubMed2000

The use of cycloplegic agents. Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology.

INTRODUCTION: Because of its advantages, topical cyclopentolate is often preferred over the gold standard, atropine. The purpose of this study was to obtain an overview over current cycloplegia protocols and to estimate the likelihood of severe complications due to the use of cycloplegics. METHODS: A questionnaire was sent to 107 German-speaking centers with a supposed high frequency of cycloplegias. RESULTS: 57 centers answered, whereby 1,112 cumulated years of experience with cycloplegia were available for analysis. The frequency of cycloplegias varied between 2 and 180/week/center, median 25/week/center. A cumulated total of 1.7 million cycloplegias was computed. The extrapolated average experience with cycloplegia was 49,000 cycloplegias/30 years. Complications which would warrant a medical follow-up of several hours (severe complications) or which led to a follow-up in a ward (very severe complications) were named 47 times and 2 times, respectively. DISCUSSION: During 30 years of a cycloplegia career with an average of 34 cycloplegias/week, one may expect 2-10 severe or very severe complications. In current practice, the patient risk of severe complications is very small. Health care professionals and parents should be informed about the frequent occurrence of harmless side effects in order to achieve a good compliance with cycloplegia.

Child↗
PubMedDate not supplied

[Effect of pilocarpine and cycloplegic substances on ophthalmic tone in healthy eyes and ones with glaucoma].

The study was carried out on the eyes of patients (aged 20-75 eyes) without glaucoma and with primary open-angle glaucoma (POAG). A single instillation of 1 or 2% pilocarpin hydrochloride did not lead to a decrease of intraocular pressure (IOP) in the eyes without glaucoma. IOP fluctuations after pilocarpin instillations were accidental and as a rule were observed both in the treated and control eyes. Instillations of the same pilocarpin solutions significantly decreased IOP in the eyes with OAG in the majority of cases (in 76% in our study), which is apparently due to removal or decrease of the canalicular block. The results of relieving tonometric pilocarpin test should be taken account of in early diagnosis of glaucoma, but the diagnostic parameters of the test should be determined more precisely. After instillation of short-acting cycloplegic drugs (1% homatropin and 0.5% tropicamide) IOP did not change either in normal or POAG eyes. These drugs are recommended for dilatation of the pupil for ophthalmoscopy in patients with anterior chamber open angle glaucoma.

Adult↗
PubMed1984

Noncycloplegic vs cycloplegic retinoscopy in pre-school children.

Refractive errors in 311 children between the ages of 18 and 48 months were assessed utilizing standard cycloplegic retinoscopy and a noncycloplegic near retinoscopy technique as promulgated by Mohindra. Results from this study indicate little agreement between the two objective refraction methods.

Child, Preschool↗
PubMed1984

Cycloplegic refractions of infants and young children: the axis of astigmatism.

Review of the cycloplegic refractions of all children who were first examined at Children's Hospital Medical Center in Boston between 1968 and 1978 revealed that 281 children between the ages of 0 and 9.5 years had astigmatism of 1 diopter (D) or greater but no other ophthalmological or neurological problems. In the 85 children under 3.5 years of age, against-the-rule astigmatism was 2.5 times more common than with-the-rule astigmatism, whereas in the 103 children over 5.5 years of age, with-the-rule astigmatism was three times as common as against-the-rule astigmatism. Eleven children who had been astigmatic as infants were recalled; follow-up refraction at ages 5-11 years revealed that all but three had at least a 0.75 D decrease in astigmatism. The remaining three had astigmatism equal in magnitude and axis to the astigmatism they had as infants. Thus, there is a high prevalence of against-the-rule astigmatism in infants and toddlers, which disappears by the time the children reach school age.

Accommodation, Ocular↗