Background: Cycloplegia is a traumatic experience for most children, a
s guttae cyclopentolate stings on instillation into the conjunctival s
ac. This may result in inadequate cycloplegia, difficulty in further e
xamination and a child who is scared of both the doctor and the ophtha
lmology department, Guttae proxymetacaine hydrochloride 0.5% (Ophthain
e, Proparacaine) is a topical local anaesthetic that does not sting on
instillation, Methods: Eighty-eight consecutive children in the paedi
atric clinic were assessed, The response of the patient to previous us
e of cyclopentolate alone was assessed by the parents of the child usi
ng a grading scheme, The use of proxymetacaine prior to instillation o
f cyclopentolate was then assessed using the same grading system, Resu
lts: Seventy per cent of the children who received cyclopentolate alon
e were assessed to have cried and been unhappy, Ninety-one per cent of
the children who received cyclopentolate after proxymetacaine were as
sessed to have shown no adverse reaction to the cycloplegia and remain
ed happy, Conclusion: This study shows that use of proxymetacaine prio
r to cyclopentolate results in atraumatic cycloplegia in children, Thi
s can confer multiple benefits on the doctor-patient relationship.