I

All children younger than 12 years, with refractive error or strabismus should undergo cycloplegic refraction in the first visit

II

Choice of cycloplegic agent

Age

Category

Drug of choice

<2 years

All children

Atropine (1%) eye ointment

2 - 5 years

With Esotropia [5]

Atropine (1%) eye ointment

Without Esotropia [3]

Cyclopentolate (1%)―Tropicacyl (1%)―Cyclopentolate (1%) (CTC)

5 - 8 years

With Esotropia [5]

Atropine (1%) eye ointment

Without Esotropia

Myopia [4]

Hyperopia [3]

Tropicamide (1%) eye drops

CTC^*

8 - 12 years

With esotropia

CTC

Without Esotropia

Tropicamide (1%) eye drops

III

Dosage of cycloplegic drugs

・ Atropine sulphate (1%): eye ointment to be instilled twice a day for 3 days.

・ Cyclopentolate (1%) and Tropicamide (1%) (CTC): 3 drops instilled at an interval of 15 minutes.

・ Tropicamide (1%): 3 drops instilled at an interval of 10 minutes each.

IV

Duration of cycloplegia

・ Atropine sulphate (1%): After 3 days of first instillation.

・ Cyclopentolate (1%) and Tropicamide (1%) (CTC): After 60 minutes of first instillation.

・ Tropicamide (1%): Within 30 - 45 minutes of first instillation.