Tropicamide (1%): An effective cycloplegic agent for myopic children

PURPOSE. To evaluate the cycloplegic effect of 1% tropicamide in myopic chi ldren and to determine whether its efficacy is associated with age, gender, iris color, ethnicity, magnitude of the refractive error, or latent error. METHODS. Four hundred sixty-nine children enrolled in the Correction of Myo pia Evaluation Trial (COMET; a multicenter, randomized, double-masked clini cal trial evaluating the rate of progression of juvenile-onset myopia in ch ildren wearing progressive-addition versus single-vision lenses) were given I drop of proparacaine in each eye followed 1 minute later by 1 drop of 1% tropicamide and then a second drop of 1% tropicamide 4 to 6 minutes later. Five accommodative responses to 20/100 letters located at 4 m and 33 cm we re obtained in each eye with an autorefractor, 20 minutes after the second drop. Residual accommodation was calculated as the difference between the m ean spherical equivalent responses obtained at the two distances. An examin er graded iris color, and ethnicity was reported by the children's parents or guardians. RESULTS. The mean residual accommodation was small: 0.38 +/- 0.41 diopters (D) in the right eye and 0.30 +/- 0.41 D in the left eye. Small but statist ically significant differences in residual accommodation were associated wi th ethnicity, but not with any of the other factors. CONCLUSIONS. Tropicamide (1%) is an effective cycloplegic agent in myopic c hildren.