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(Investigative Ophthalmology and Visual Science. 2001;42:1728-1735.)
© 2001 by The Association for Research in Vision and Ophthalmology, Inc.

Tropicamide (1%): An Effective Cycloplegic Agent for Myopic Children

Ruth E. Manny1, Mohamed Hussein2, Mitchell Scheiman3, Daniel Kurtz4, Kathy Niemann5, Kathleen Zinzer3 and the COMET Study Group,6

1 From the College of Optometry, University of Houston, Texas; 2 University Medical Center, Stony Brook, New York; 3 Pennsylvania College of Optometry, Philadelphia; 4 New England College of Optometry, Boston, Massachusetts; and the 5 University of Alabama School of Optometry, Birmingham.

PURPOSE. To evaluate the cycloplegic effect of 1% tropicamide in myopic children 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 Myopia Evaluation Trial (COMET; a multicenter, randomized, double-masked clinical trial evaluating the rate of progression of juvenile-onset myopia in children wearing progressive-addition versus single-vision lenses) were given 1 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 were obtained in each eye with an autorefractor, 20 minutes after the second drop. Residual accommodation was calculated as the difference between the mean spherical equivalent responses obtained at the two distances. An examiner 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 statistically significant differences in residual accommodation were associated with ethnicity, but not with any of the other factors.

CONCLUSIONS. Tropicamide (1%) is an effective cycloplegic agent in myopic children.




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