Aim: To compare the efficiency of 1% tropicamide eyedrop with different techniques between 5-minute instillation and 10-minute instillation with cotton-tipped applicator methods in diabetic patients.

Method: In a randomized controlled study, one drop of 1% tropicamide was instilled in one eye for every 5 minutes while maintaining a 10-minute instillation with cotton-tipped applicator in another eye.  Horizontal pupil diameter was measured before instillation and 10, 20, 30 and 40 minutes after instillation and compared between groups. Duration of diabetes, level of fasting blood sugar and HbA1C were recorded in each group. Anterior chamber depth grading was done to exclude angle closure group. Blood pressure, ocular surface irritation and degree of discomfort were also collected before and after the instillation.

Results: A cohort of 40 patients with 17 male and 23 female had a mean age of 58.48 years old. Mean horizontal pupil diameter after 40 minutes in 5-minute and 10-minute instilled eyes with cotton-tipped applicator were 6.60 mm and 6.63 mm respectively (P = 0.66, Pair-T Test). 17.5 percent of 10-minute instillation with cotton-tipped applicator methods had a mild degrees of discomfort compared to 2.5 percent of 5-minute instillation method.

Conclusions: Both techniques had an equal effect in terms of mydriasis. Pupil size dilation at every interval after instillation in both methods had no significant difference and was ufficient for successful ophthalmoscope.