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11.5 Mydriatics and cycloplegics

Antimuscarinics
Atropine sulphate drops 0.5% and 1%, ointment 1%, minims
Cyclopentolate hydrochloride drops 0.5% and 1%, minims
Homatropine drops 2%, minims
Tropicamide drops 0.5% and 1%, minims

Notes:

1. Tropicamide produces rapid-onset mydriasis of short duration, reaching its maximal effect at 40-60minutes. Recovery occurs over 6-8hours.

2. Cyclopentolate has a longer duration of action, reaching its maximal effect in 30-60minutes. This lasts for about 45minutes; complete recovery may take up to 24hours.

3. The effects of atropine can last for up to 14 days. Systemic toxicity from atropine absorption can occur quite often especially in elderly or very young patients. In particular elderly patients may become confused.

 

Sympathomimetics

Phenylephrine hydrochloride 10% drops, 2.5% and 10% minims.

 

Combination

Phenylephrine/tropicamide (Mydriasert) ophthalmic insert (prior to cataract surgery) 

 

 

For link to BNF section: 11.5 Mydriatics and cycloplegics