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ABSTRACT
Atropine is accepted generally as the most efficient cycloplegic agent. Although it is considered a relatively safe drug, toxic local and systemic side effects do occur. The recommended regimen for atropine cycloplegia has been 7 to 10 applications within 3 to 4 days. We compared the cycloplegic effect of four instillations of atropine drops to the effect of eight instillations. The results showed that the cycloplegia obtained after eight instillations was not greater than after four instillations.
INTRODUCTION
In the young esotropie patient, maximum cycloplegia is essential. Several studies have indicated that the use of atropine is essential in children 6 years old or younger to uncover the maximum amount of hyperopia.1"3 The traditional technique recommended by von Noorden for an atropine retinoscopic examination has been to instill "one drop ... in each eye, morning and night for 3 days. On the 4th day, the day of examination, one drop is to be instilled in each eye 1 hour prior to the appointment time.*4 Yet, different ophthalmologists use different regimens.410 Systemic side effects, chiefly due to mucosal absorption, have been associated with excessive use of atropine and include fever, tachycardia, fall in blood pressure, hallucinations, circulatory collapse, and death.11-12 Taking into account the great variability in atropine cycloplegia techniques and its dangerous systemic side effects, we conducted a study comparing the use of eight instillations of atropine as to four only, for the purpose of cycloplegia. The study was designed in an attempt to reduce side effects, parents' burden, and child's discomfort, while still obtaining full cycloplegia in children.
PATIENTS AND METHODS
The population studied included consecutive hyperopic children that attend the pediatric ophthalmology unit at the Ichilov Hospital, Tel-Aviv Medical Center. The parents were requested to administer atropine in the form of 1% solution to both eyes of the patient four times: three times 1 day...