Formulary

11.5 Mydriatics and cycloplegics

First Line
Second Line
Specialist
Hospital Only
Tropicamide
  • Single use preservative-free eye drops 0.5%, 1% (£12.33 = 0.5% x 20 unit dose (0.5ml))

Notes

  1. Tropicamide activity is approximately 4-6 hours and makes it ideal for mydriasis prior to ophthalmic examination.

Antimuscarinics dilate the pupil and relax the ciliary muscle resulting in mydriasis and cycloplegia. They can rarely raise intra-ocular pressure (IOP) and they should be used with caution in those patients susceptible to angle closure, unless already treated with laser or surgery.

Atropine
  • Eye drops 1% (£118.02 = 10ml)
  • Single use preservative-free eye drops 1% (£17.13 = 20 unit dose (0.5ml))

Notes

  1. Atropine has the longest activity, sometimes up to a week.
Cyclopentolate
  • Eye drops 0.5%, 1% (£8.08 = 5ml)
  • Single use preservative-free eye drop 0.5%, 1% (£12.87 = 1% x 20 unit dose (0.5ml))

Notes

  1. Cyclopentolate activity lasts for up to 24 hours and reduces ciliary spasm and pain.
Homatropine
  • Eye drops preservative-free 1% (available from special order manufacturers)

Sympathomimetics

Phenylephrine
  • Single use preservative-free eye drops 2.5%, 10% (£13.08 = 2.5% x 20 unit dose (0.5ml))

Notes

  1. Used for mydriasis in diagnostic procedures and prevention of posterior synechiae. Higher doses give little additional benefit and may cause cardiovascular side effects.