1% Cyclopentolate hydrochloride: another look at the time course of cycloplegia using an objective measure of the accommodative response.

The time course of cycloplegia was measured by monitoring residual accommodation after the application of 1 drop (29.3 microliters) of 1% cyclopentolate hydrochloride. Three different measures of residual accommodation were made, one objective assessment with an optometer, and two subjective assessments similar to those used by previous investigators. Pupil diameter was also measured in a subgroup of individuals to compare the time course of the induced mydriasis to that of the cycloplegia. When residual accommodation is measured objectively, maximum cycloplegia occurs 10 min after the application of 1% cyclopentolate hydrochloride in individuals with light irides. This result suggests that the standard clinical protocol of delaying refraction 30 to 60 min after the application of cyclopentolate hydrochloride may be too conservative for individuals with light irides. For individuals with dark irides, 30 to 40 min is required for maximum cycloplegia, and the magnitude of residual accommodation in these individuals is similar to that found in light iris individuals at 10 min. When subjective measures are used to estimate residual accommodation, more accommodation is present and the time at which maximum cycloplegia occurs is delayed for individuals with light irides. These results are in agreement with previous studies using subjective techniques. Regardless of iris color or measurement method, the time course for pupil dilation is not the same as the time course for cycloplegia.