Cycloplegic Effect of 1% Atropine Compared to 1% Cyclopentolate − 1% Tropicamide Combination in Children

Objective: To compare the cycloplegic effect of 1% Atropine to 1% cyclopentolate plus 1%Tropicamide (CT) combination in children. Methods: This was a cross-over interventional study among children aged 0–15 years in our eye clinic in year 2017. The children were selected using a stratified sampling method. Each child had a non-cycloplegic refraction then refraction after instillation of a drop of 1% Cyclopentolate and 1% Tropicamide 5 minutes apart in the left eye.Parents were given 1% Atropine drops to be instilled twice daily for three days in the same eye before the return visit 3 weeks after and refraction was repeated. Results: The children were aged between 4 months and 15years with a higher number of females (60.7%). The difference between the mean of the spherical equivalent of non-cycloplegic refraction and that for CT combination was statistically significant (P < 0.05) at one hour while the mean of the spherical equivalent of refraction with atropine was comparable to that with CT combination. There was no significant difference between the mean of the spherical equivalent of refraction done with an auto-refractor and that done by retinoscopy. Conclusion: African children aged 0–15 years should have cycloplegic refraction using retinoscopy or auto-refractor one hour after instilling CT combination as a substitute for 1% Atropine.