A randomized comparison study of drop versus spray topical cycloplegic application

Purpose: To evaluate the acceptance of ocular spray administration. Methods: A randomized, single-masked comparison in a cohort of children from 3 to 13 years. Assessment of patient pain was recorded on a visual analog scale. Cycloplegia was assessed by an ophthalmologist masked to the assignment. A questionnaire was used to assess patient acceptance. 126 patient participated. The average age was 7.7 years for spray, 7.1 for drops. Results: Pain (higher number = more painful): means: 41/100 for spray; 35/100 for drops (P=0.28). No difference in cycloplegia noted (i.e., satisfactory in all subjects). Subjective acceptance: high in both patient groups, but a preference for spray was noted (P=0.06). No untoward drug reactions occurred with either method. Conclusions: Cycloplegia spray was as acceptable, or more acceptable than drops. Cycloplegia was comparable for the two methods. Spray application of cycloplegia drugs is a satisfactory route of topical administration for children.