A COMPARISON OF DROP INSTILLATION AND SPRAY APPLICATION OF CYCLOPENTOLATE

Title A COMPARISON OF DROP INSTILLATION AND SPRAY APPLICATION OF CYCLOPENTOLATE
Author, Co-Author Esaam Ismail, Michael Rouse, Paul De Land
Topic
Year
1992
Day
Sunday
Program Number
Poster 26
Room
Great Hall
Affiliation
Abstract The administration of topical ophthalmic drugs to a young child can be a stressful and arduous event for both child and clinician. Administration of topical mydriatrics by spray application to the closed eye has been compared to traditional drop instillation and found to be equally efficacious as well as less traumatic for the child and clinician. Although spray application of cycloplegic agents has been suggested, there are no published studies comparing the efficacy of spray to traditional drop administration. This study compared the objective cycloplegic refraction of 37 hyperopic children (ages 18 months to 6 years) obtained once by spray application to the closed eyes, and later by a one drop instillation to the open eyes. Patients were initially screened for hyperopia using a masked noncycloplegic retinoscopy with loose trial lenses. Spray or drop administration of cycloplegia (1% cyclopentolate hydrochloride; 1% Spectro Pentolate) was randomized and each patient returned within two weeks for the alternative method. A masked cycloplegic retinoscopy was performed 20 minutes after administration for patients with "light" iris colors and after 40 minutes for "dark" irides. One examiner conducted all cyclopentolate administrations, while a separate examiner (masked to application method) conducted all refractive testing. For right eyes, the mean spherical equivalent refraction for spray application was 1.67D (SD=1.62D) and 1.70D (SD=1.62D) for the drop instillation. Results were similar for the left eyes. These small differences were not statistically significant (ANOVA, F=0.05, P=0.82). The absolute difference in spherical equivalent was 0.50D or less in 93% of all subject eyes. In addition, a scaling system was created to rate the ease of administration and patient's response to each method. Using an exact test of marginal homogeneity the response rating for the spray method was significantly better (P=0.016). The spray application of cyclopentola
Affiliation of Co-Authors
Outline