The Methods of Atropinization for Cycloplegic Refraction in Esotropic Children

ABSTRACT

Retinoscopy was performed on 90 esotropic children (180 eyes) younger than 6 years with cyclopentolate-homatropine and atropine. This procedure involves the instillation of a combination of cyclopentolate 1% and homatropine 5% on the initial visit, (ollowed by the instillation of atropine 1% two to four weeks later. In group 1, the parents administered atropine to both eyes of the patient three times a day for 3 days prior to the refraction, and for group 2, atropine was administered twice a day alternately to both eyes for 5 days. Atropine revealed +0.74 diopters more hyperopia than cyclopentolate-homatropine in group 1, and +0.68 diopters more in group 2, No statistically significant difference in cycloplegic effect of atropine was found between the two groups. After use of the atropine, side effect of facial flushing occurred in 15 patients (30%) in group 1, and in 5 patients (12%) in group 2. This difference is statistically significant (p<0.05). The results imply that in clinical practice 5 days of alternate twice-daily instillation can be substituted for conventional "full" atropinization for 3 days.