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Cyclopentolate is often chosen as a milder, shorter-lasting, cycloplegic alternative to atropine, another cycloplegic agent which lasts much longer. Tropicamide is an even shorter-lasting cycloplegic than cyclopentolate, but is less reliable for finding latent hyperopia. Cyclopentolate drops act rapidly to dilate the pupil. [5]
Spasm of accommodation is frequently resistant to treatment. However, some patients do find relief through the use of daily eye dilation with cycloplegic drops. One side effect of cycloplegic drops is that they often have BAK as a preservative ingredient, which, with daily use, can erode the tear shield:
[5] [12] To keep the specific drug in the therapeutic window using eye drops the topical must be applied approximately every 30 minutes in order to be fully effective. [ 5 ] [ 12 ] Having to apply eye drops every 30 minutes would be nearly impossible for anyone and is not the ideal mechanism by which to deliver such drugs to the eye.
All cycloplegics are also mydriatic (pupil dilating) agents and are used as such during eye examination to better visualize the retina. When cycloplegic drugs are used as a mydriatic to dilate the pupil, the pupil in the normal eye regains its function when the drugs are metabolized or carried away.
Tropicamide, sold under the brand name Mydriacyl among others, is a medication used to dilate the pupil and help with examination of the eye. [3] Specifically it is used to help examine the back of the eye. [4] It is applied as eye drops. [3] Effects occur within 40 minutes and last for up to a day. [3]
Apraclonidine (), also known under the brand name Iopidine, is a sympathomimetic used in glaucoma therapy. It is an α 2 adrenergic receptor agonist and a weak α 1 adrenergic receptor agonist.
Mydriasis is the dilation of the pupil, usually having a non-physiological cause, [3] or sometimes a physiological pupillary response. [4] Non-physiological causes of mydriasis include disease, trauma, or the use of certain types of drugs.
A study of 2,523 children in grades 1 to 8 (age, 5–17 years) found nearly one in 10 (9%) have at least −0.75 diopters of myopia. [149] In this study, 13% had at least +1.25 D hyperopia (farsightedness), and 28% had at least 1.00-D difference between the two principal meridians (cycloplegic autorefraction) of astigmatism .