EFFICACY OF TROPICAMIDE 1% VERSUS CYCLOPENTOLATE 1% IN CYCLOPLEGIC REFRACTION: A RANDOMIZED CLINICAL STUDY

Abstract

Accurate cycloplegic refraction is important in pediatric and adolescent populations, as active adjustment mask real refractive errors and lead to improper visual correction. Cycloplegic agents such as Tropicamide 1% and Cyclopentolate 1% are commonly used to eliminate accommodation during refraction. While Cyclopentolate is considered more potent in producing cycloplegia, Tropicamide offers advantages such as faster onset and shorter recovery time.

OBJECTIVE To compare the effectiveness of Tropicamide 1% and Cyclopentolate 1% in achieving adequate cycloplegia for accurate cycloplegic refraction.

METHODOLOGY This randomized, parallel-group clinical study included 50 children aged 5–15 years with suspected refractive errors. Participants were recruited through convenient sampling and randomly allocated into two groups. Each participant received two drops of the assigned agent in each eye, 5 minutes apart. Baseline visual acuity and objective refraction were recorded, followed by cycloplegic refraction after adequate dilation. Spherical equivalent was calculated, and the difference between pre- and post-cycloplegic values was taken as the primary outcome.

RESULTS No significant difference was found in baseline characteristics or pre-cycloplegic SE. Post-cycloplegic SE showed significant difference in the right eye (p = 0.035), while the left eye was non-significant (p = 0.117). The change in SE was significantly higher in the Cyclopentolate group (p < 0.001). Adverse effects were more frequent with Cyclopentolate.

CONCLUSION Cyclopentolate provides stronger cycloplegia but with more side effects, while Tropicamide offers better tolerability. Selection should balance accuracy and patient comfort.