Cycloplegic Effects of Atropine and Tropicamide in Young Children with Refractive Error: A Quasi-experimental Study

Background: Cycloplegia is the paralysis of the ciliary muscle of the eye, which causes pupil dilation and accommodation paralysis. This can be accomplished by injecting cycloplegic drugs into the conjunctival sac, such as atropine, cyclopentolate, and tropicamide. The aim of this study was to compare the cycloplegic effects of atropine and tropicamide in young children with refractive error. Methods: This quasi-experimental study was conducted at the Department of Pharmacology and Therapeutics in collaboration with the Ophthalmology Department of Rajshahi Medical College Hospital, Rajshahi. This study was conducted over 1 year from July 2021 to June 2022. The study involved 49 young children (98 eyes) with an age range of 2-10 years and refractive error at least in one eye as minimum inclusion criteria. The collected data were analyzed using Statistical Package for Social Sciences (SPSS) software, version-23.0. Results: A total of 49 young children (98 eyes) with refractive errors were enrolled in the study. Among 59.2% of the respondents' age was between 6 to 8 years. More than half of the respondents were girls, which was proportionately more than boys. Among the respondents 53% had myopia and the remaining had hypermetropia. Here on hyperopic young children (n=23) mean (±SD) value for cycloplegic refraction of both eyes after using 1% atropine eye drop was + 2.98 (±1.85) D and +2.79 (±1.89) D after using 1% tropicamide eye drop. Again, on myopic young children (n=26) mean (±SD) value for cycloplegic refraction of both eyes after using 1% atropine eye drop was -4.88 (±2.86) D and -5.28 (±3.37) D after using 1% tropicamide eye drop. None of the drugs caused constipation or any psychological problem. 1% tropicamide eye drop caused eye irritation and redness in 12% of the respondents. Using 1% atropine eye drops 38.8%, 4.1% and 2% of young children suffered from fever, dry mouth, and palpitation respectively. Comparing cycloplegic effect of both eye drops on hyperopic and myopic young children difference was found statistically significant (p<0.05). Conclusions: It was found that atropine had significantly (P< .05) more cycloplegic effect than tropicamide on both hyperopic and myopic young children but atropine produced more adverse effects.