NHS Dudley Health Economy Medicines Formulary
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11.5 Mydriatics and cycloplegics

General Guidance

  • Antimuscarinics vary in potency and duration of action.
  • Darkly pigmented iris is more resistance to pupillary dilation and caution should be exercised to avoid over dosage.
  • Mydriasis may precipitate acute angle-closure glaucoma. Those at special risk are usually aged over 60 years and hypermetropic (long-sighted)
  • Patients should be warned not to drive for 1-2 hours after mydriasis.
  • Cyclopentolate 0.5% or 1% is useful for refraction in children.

Recommended drugs

Atropine eye drops

Tropicamide (for eye examinations) 


Drug Traffic Light Key:

Green – On Formulary

Amber – Restricted use, see local guidelines      

Purple – Specialist use/initiation

Red – Non Formulary


Relative Costs Key (where indicated):

£££££ - high

£££ - moderate

£ - low

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