Tropicamide sterile eye drops are indicated for dilating (enlarging) the pupil, allowing the doctor to examine the back part of the eye. It is commonly used before eye examinations, including cycloplegic refraction and fundus examination.
Tropicamide eye drops can also be used before and after ocular surgery.

Tropicamide, which is structurally related to atropine to a certain extent, produces mydriasis and cycloplegia by paralyzing the parasympathetic system. Tropicamide is a parasympatholytic agent that acts by inhibiting the function of the parasympathetic nervous system. Since acetylcholine serves as the neurotransmitter at the receptor sites of the parasympathetic nervous system, tropicamide competes with acetylcholine at these receptor sites and blocks its action. As a result, mydriasis occurs due to the unopposed activity of the dilator pupillae muscle along with cycloplegia.

Tropicamide causes visible pupil dilation within 5 minutes. Maximum dilation is achieved within 20-25 minutes, and the pupil usually returns to its normal size within approximately 6 hours. The onset of action is rapid, but the effect subsides within 45-60 minutes after the final instillation. Therefore, the optimal time for retinoscopy is approximately 20 minutes after administration of the last drop.

For refraction: Instill 1 or 2 drops into the eye(s), then repeat after 5 minutes if necessary. If the patient is not examined within 20 to 30 minutes, an additional drop may be instilled to prolong the mydriatic effect.

For examination of the fundus: Instill 1 drop into the eye(s) 15 to 20 minutes before examination.

Drugs with atropine-like action, tricyclic antidepressants, various H1 antihistamines, anticholinergic agents, anti-Parkinson medicines, phenothiazines and neuroleptics may enhance the effect of tropicamide when used together.

Not recommended in patients with narrow-angle glaucoma or known hypersensitivity to any ingredient of the preparation.

A brief burning sensation may occur after eye instillation. In children, it may cause behavioral disturbances, psychotic reactions, and rarely cardio-respiratory collapse. It may also affect alertness during driving or operating machinery. Other possible effects include increased intraocular pressure, allergic reactions, dry mouth, tachycardia, and headache.

Pregnancy Category C. Tropicamide should be used during pregnancy only if clearly necessary. It is unknown whether it passes into human breast milk. Since many drugs are excreted in milk, caution is advised when used in breastfeeding women.

If necessary, a miotic antidote may be used after examination. To minimize systemic absorption, the patient should press the tear duct for 2–3 minutes after instillation. Elderly patients should use mydriatic and cycloplegic agents with caution.

Symptoms such as facial flushing, rapid pulse, dry mouth, reduced sweating, and increased body temperature may indicate overdose. In case of accidental ingestion, immediate medical attention is required. A miotic agent may be used to counteract the effects if needed.

Mydriatic and Cycloplegic agents

Store at room temperature and protect from light. The bottle should ideally be used within one month after first opening.