PEDIATRIC CYCLOPLEGIA - A NEW APPROACH

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.