title: A Clinical Randomized Trial Comparing the Cycloplegic Effect of Cyclopentolate Drops Applied to Closed Eyelids Versus Open Eyelids.
abstract: OBJECTIVE
  Adequate cycloplegia and dilation are required for refraction and fundus exam in children. Standard practice is to instill cycloplegic drops in the inferior cul-de-sac, and this is often traumatic for children. Our study assesses the use of cyclopentolate on closed lids as a method of instillation for ensuring complete cycloplegia.
  
  
  METHODS
  Ninety children presenting for annual refraction were enrolled. Three were excluded as they did not finish the testing. One drop of Alcaine®and one drop of cyclopentolate HCL 1% were used in each eye. Cyclopentolate drops were placed on the inner canthus near the lid margin on the closed eye and directly onto the conjunctiva of the fellow eye.
  
  
  RESULTS
  Overall, 145/174 eyes (83%) were fully cyclopleged with one drop. The methods of instillation were equally successful (seventy-two indirect vs. seventy-three direct). Age, eye color, spherical refractive error, astigmatic refractive error, and presence of amblyopia on the study visit played no role in the success of either method. Dark irises where the pupil margin was clinically indistinguishable had the largest number of failures (n = 17/44) in comparison to light irises (12/130), but had an equal amount of failures for both direct and indirect methods.
  
  
  CONCLUSIONS
  Placing one drop of cyclopentolate HCL 1% on a closed eyelid had a success rate for complete cycloplegia that was equivalent to placing one drop directly on the cornea.
authors: From the Orthoptic Clinic, Eye Care Centre, Saskatoon Health Region, Saskatoon, Saskatchewan.
authors: Jocelyn
authors: J
authors: Zurevinsky
authors: From the Orthoptic Clinic, Eye Care Centre, Saskatoon Health Region, Saskatoon, Saskatchewan.
authors: Kallie
authors: K
authors: Sawchuk
authors: Department of Community Health and Epidemiology, University of Saskatchewan.
authors: Hyun J
authors: HJ
authors: Lim
authors: Clinical Research Support Unit, College of Medicine, University of Saskatchewan.
authors: Chel Hee
authors: CH
authors: Lee
authors: Department of Ophthalmology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada.
authors: Shehla
authors: S
authors: Rubab
mesh_terms: D002648:Child; D002675:Child, Preschool; D003519:Cyclopentolate / Q000008:administration & dosage*; D005127:Eye Color / Q000187:drug effects; D005143:Eyelids / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000008:administration & dosage*; D009883:Ophthalmic Solutions; D011680:Pupil / Q000187:drug effects; D042262:Retinoscopy
chemical_list: D009184:Mydriatics; D009883:Ophthalmic Solutions; D003519:Cyclopentolate
keywords: cycloplegia; cycloplegia for children; eye drop application; refraction in children