The use of cycloplegic agents. Results of a 1999 survey of German-speaking centers for pediatric ophthalmology and strabology

Abstract

INTRODUCTION. Because of its advantages, topical cyclopentolate is often preferred over the gold standard, atropine. The purpose of this study was to obtain an overview over current cycloplegia protocols and to estimate the likelihood of severe complications due to the use of cycloplegics. METHODS. A questionnaire was sent to 107 German-speaking centers with a supposed high frequency of cycloplegias. RESULTS. 57 centers answered, whereby 1,112 cumulated years of experience with cycloplegia were available for analysis. The frequency of cycloplegias varied between 2 and 180/week/center, median 25/week/center. A cumulated total of 1.7 million cycloplegias was computed. The extrapolated average experience with cycloplegia was 49,000 cycloplegias/30 years. Complications which would warrant a medical follow-up of several hours (severe complications) or which led to a follow-up in a ward (very severe complications) were named 47 times and 2 times, respectively. DISCUSSION. During 30 years of a cycloplegia career with an average of 34 cycloplegias/week, one may expect 2-10 severe or very severe complications. In current practice, the patient risk of severe complications is very small. Health care professionals and parents should be informed about the frequent occurrence of harmless side effects in order to achieve a good compliance with cycloplegia.