Question

During retinoscopy of a 30 year old male, which cycloplegic is used routinely?

• A. Atropine 1% ointment
• B. Cyclopentolate 1% drop
• C. Homatropine 2% drop
• D. None of the above

Hint:

At 20 to 40 years the accommodative reserve is low, so routine cycloplegia is not needed.

Answer 1

The Correct Option is D

Step 1: Cycloplegics paralyse the ciliary muscle and abolish accommodation so that the true refractive error can be measured during retinoscopy. They are essential mainly in children and young people who have a strong accommodative reserve.

Step 2: The need for cycloplegia falls with age. Children below 5 years need atropine 1% ointment, and those aged 15 to 20 years may need homatropine, cyclopentolate or tropicamide.

Step 3: A 30 year old is an adult in the 20 to 40 year age group. In this group there is no need for routine cycloplegia, because the accommodative reserve is already weak. Hence none of the listed cycloplegics is used routinely.

Step 4: Cycloplegia in adults is reserved for special situations such as spasm of accommodation, accommodative asthenopia, a small pupil, or when retinoscopy findings do not match the subjective acceptance. Therefore the answer is none of the above.