Cycloplegic refraction is the gold-standard technique for measuring refractive error in children.1 Young children have stronger accommodation than teenagers and adults, which may interfere with accurate refraction unless fully relaxed. To address this, cycloplegic agents such as cyclopentolate hydrochloride (henceforth cyclopentolate) are routinely used to temporarily paralyse the ciliary muscle, preventing accommodative interference.
To improve comfort upon cyclopentolate instillation, practitioners may use topical anaesthetics such as proxymetacaine hydrochloride (henceforth proxymetacaine) beforehand. Cyclopentolate causes stinging, which lasts for 63 seconds on average, compared to just three seconds with proxymetacaine.2
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