XI. Cycloplegia – Contd.

Retinoscopy is the Objective method of assessing the refraction of the eye. To measure the Static Refraction the accommodation should be at rest.

This can be achieved by voluntary relaxation of accommodation by the patient, by noncycloplegic method of inhibiting accommodation by Fogging or by using cycloplegics to prevent accommodation.

Relaxation of accommodation is difficult in younger age group and in cases with spasm of ciliary muscle. Fogging is also not effective in these situations. So, cycloplegic refraction is the answer.

Cycloplegia is used up to the age of 10 – 15 years (may be up to 20 years).Also in cases with over action of accommodation and in all cases of Convergent strabismus.

Commonly used Cycloplegics

atropine Sulphate (0.5 – 1%)
(lower strength below 5 years of age)
Used for cycloplegia in children below 7 – 10 years of age,
in cases with ciliary spasm and in Convergent Strabismus.
Ointment or drops applied thrice daily for at least three days. Amount of cycloplegia (change of refractive power) achieved is +1.0 Dioptre (more than the actual static refraction of the eye).Effect lasts for 2 weeks.


Homatropine Hydrobromide (1 – 2%)
Drops applied at 15 minutes interval for 6-8 times.
Retinoscopy is done after 1 hour.
Amount of cycloplegia (change of refractive power) achieved is +0.50 Dioptre (more than the actual static refraction of the eye).Effect lasts for 2 days.

Cyclopentolate Hydrochloride (0.5-1%)
Drops applied 2-3 times at 5 minutes interval.
Retinoscopy is done after 30 minutes.
Amount of cycloplegia (change of refractive power) achieved is +0.50 Dioptre (more than the actual static refraction of the eye).Effect lasts for 8 hours.

Tropicamide (0.5-1%)
Drops applied 2-3 times at 5 minutes interval.
Retinoscopy is done after 30 minutes.
Amount of cycloplegia (change of refractive power) achieved is +0.50 Dioptre (more than the actual static refraction of the eye).Effect lasts for 8 hours.
http://en.wikipedia.org/wiki/Tropicamide
http://en.wikipedia.org/wiki/Phenylephrine
Post Cycloplegic Subjective Refraction (Post Mydriatic Test) is to be done in possible cases.