Antimuscarinic mydriatic / cycloplegic
Cyclopentolate hydrochloride
Brand names: Mydrilate, Minims Cyclopentolate
Adult dose
Dose: 1 drop (0.5–1%); repeat after 5–10 min for full cycloplegia
Route: Ophthalmic
Frequency: PRN diagnostic / 1–4× daily for cycloplegia
Clinical pearls
- RCOphth: refraction in children, anterior uveitis prophylaxis of synechiae
- Use 0.5% in infants <1 year (systemic absorption); 1% adults / older children
- Punctal occlusion reduces systemic effects
Contraindications
- Closed-angle glaucoma / shallow anterior chamber
- Hypersensitivity
Side effects
- Stinging
- Photophobia
- Blurred vision
- Acute angle closure (susceptible)
- Systemic anticholinergic effects (especially infants — apnoea, GI ileus reported)
- Hallucinations / behaviour change (paediatric)
Interactions
- Other anticholinergics
Monitoring
- Pupil size
- IOP
- Behaviour (paediatric)
- Anterior chamber
Reference: BNF; RCOphth; Royal College of Ophthalmologists paediatric guideline; https://bnf.nice.org.uk/drugs/cyclopentolate-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Acute Red Eye / Vision Loss Screen · RCOphth 2020; NICE CKS
- Idiopathic Intracranial Hypertension · ABN; consensus 2018
- Acute Red Eye Assessment · RCOphth / AAO
- Acute Angle Closure Glaucoma · RCOphth / EGS Guidelines
- Retinal Detachment · RCOphth Guidelines / EURETINA
- Diabetic Retinopathy — Screening and Management · NICE NG28 2016 / NHS DES Programme