A 3 year old child comes for suspected squint. A refraction is ordered, what is the drug of choice?
High-Yield Explanation
The most common cause of squint in child is accommodative esotropia i.e. due to uncorrected refractive error which in child is mostly hypermetropia So for refraction testing we need cycloplegic drug to paralyse the ciliary muscles and reveal the true refraction of child. The smaller the children the more powerful the accomodation. The most powerful cycloplegic drug is atropine and is indicated in children below 5 years. Tropicamide is less potent cycloplegic Pilocarpine is a parasympathomimetic and thus not used Lidocaine is local anesthetic and not a cycloplegic