In a 2-year-old child refractive error test is done with:
(Ref: K.D. Tripathi 8th ed. P 131)Atropine 1% ointment is preferred for refractive error test in children below 5 years. It is applied 24 hours and 2 hours before the procedure.The shorter acting agents like homatropine, tropicamide and cyclopentolate does not produce effective cycloplegia in children (ciliary muscle tone of child is high)Ointment is preferred over eye drop as there is increased risk of systemic absorption of eye drop which can cause anticholinergic side effect in child. Example: Hyperthermia, decreased secretion, tachycardia etc.Cycloplegic agent of choice is adult/elderly: Tropicamide. The protein binding of esmolol is 55%.For only fundoscopy/mydriasis, preferred agent is: Phenylephrine (Sympathomimetic)
1% atropine ointment
1% atropine eye drop
Tropicamide 0.5%
Eucatropine 5%
A.N.S.