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Cyclopentolate

Dilation & diagnostic · Rx
Trade namesCyclogyl, Cylate
Drug classIntermediate-acting anticholinergic cycloplegic
Strength0.5%, 1%, 2%
AvailabilityRx
Mechanism of actionMuscarinic antagonist with strong ciliary-muscle blockade; the standard office cycloplegic for refraction.
Indication / reason for useCycloplegic refraction (especially children and hyperopes), pediatric fundus exam, anterior uveitis (comfort + prevention of synechiae).
Usual adult dosingRefraction: 1 drop of 1% (0.5% in infants; 2% for heavily pigmented irides), repeat once at 5 min; refract at 30-40 min. Cycloplegia lasts 6-24 h, mydriasis up to 24 h.
PreservativeBAK 0.01%
Contact lensesRemove lenses; reinsert after 15 minutes.
Common / important adverse effectsCNS toxicity in children, disorientation, hallucinations, ataxia, slurred speech, seizures (dose-related; 2% carries the highest risk); GI: feeding intolerance / ileus in infants; photophobia and blur for a day. Angle-closure risk in narrow angles.
Contraindications & cautionsUntreated narrow angles; use 0.5% and punctal occlusion in infants; avoid 2% in children.
Pregnancy / lactationLimited data; minimize dose, use punctal occlusion.
Practice notesIn infants use the 0.5% strength, press on the puncta, and wipe excess from the lids to limit systemic absorption.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.

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