Cyclopentolate eye drops - 6 drops per eye??

[scroopy]

Hello!

What could the reason be for an ophthalmologist to ask you to put in 6 drops of cyclopentolate in each of your kid's eyes before an eye exam?

Some background: I live in Europe, and this week I took my 8 year old DD for a routine eye test.

The ophthalmologist said she had amblyopia (lazy eye), but he was unable to prescribe glasses, as she really needed the eye drops in order for him to be able to do a proper test.
He prescribed the drops (cyclopentolate 1%) and said to come back this week. He wrote down that before the test, I needed to put 6 drops in each of her eyes: starting 2 hours before the appointment, each drop 20 minutes apart, 6 drops in each eye (total 12). I know it's not a misunderstanding - he drew a timeline and everything.

I bought the eye drops and read the safety leaflet. It says, for DD's age, to use just 1 drop per eye (or 2 for darker eyes) around 40 minutes before the test.

Every NHS leaflet I can find online about how to prepare for an eye test gives the same dosage.

I emailed the doctor to ask if his dosage was correct, and I just got a call from his secretary basically saying "he knows what he's prescribing, just do it", but not explaining why this was 6 times the usual amount (DD has very clear blue eyes).

I emailed back explaining that I won't do something that I don't understand, so to please let me know why the doctor thinks so much might be needed.

If I don't get a sensible answer, I'm planning to go to another ophthalmologist - worst case scenario is that they'll ask me to do the same, and then I'll know it's either a local thing, or something very wrong with my daughter's eyes (!)

I was wondering though if this had happened to anyone else, or if any eye specialists reading this might know why so many drops would be needed?

Thanks in advance

[underneaththeash]

That's a lot of cyclopentalate, especially in blue eyes, it can increase the risk of adverse CNS reactions.
However, we used to cycloplege using atropine, which is more potent.
There can be ocassions that you use a little more, for example, if you get an ingrained pseudomyopia.

However, I haven't seen the patient. I'd email again and ask why.

[scroopy]

Thanks for your message underneaththeash!

An update:

The initial doctor didn't answer my second email asking why. So I called 3 hours before the appointment, and another assistant told me "the doctor has answered all your questions already".
To which I replied he very much hadn't, and cancelled.

I booked another appointment for two days later (today) in the local private hospital. It took place this morning and couldn't have gone more smoothly. The doctor had a look at DD's eyes, sent us to the nurse who was lovely and funny and put 2 drops in each eye only, and 30 minutes later we had a prescription for glasses and patches. We need to patch for 3 hours a day, and thankfully it doesn't have to be during school hours - which would have been an issue.
DD already wants to try a patch, but we'll wait until her pupils stop being the eyes of saucers. We've already bought the glasses, so hopefully from next week we can start correcting this.

I'm very glad DD didn't have 6 drops, because after only 2 drops in each eye, she was giddy in the hospital waiting room, saying "whoo I'm going to fall over" and pointing at everything that looked funny around us (which was every person, chair and poster in the room). She was basically high: super-chatty, and fidgety, and giggly. I don't think it was the power of suggestion either, as I hadn't mentioned anything might happen except her vision would get blurry, and the nurse hadn't either. It was like being on a night out with a friend who's taken too much of whatever they're having, but is having a fun time with it. Even outside the hospital, she was moonwalking on the pavement while we waited for a cab.