At-Home Pupil Dilation During the COVID-19 Pandemic in the Pediatric Population

Purpose: To evaluate caregivers' perspectives, challenges, and difficulties associated with at-home pupil dilation (AHPD) during the coronavirus disease 2019 (COVID-19) pandemic. Methods: In this retrospective questionnaire study, a pediatric ophthalmologist determined eligibility for AHPD in children younger than 6 years. Cyclopentolate 1% eye drops were prescribed. Age was recorded and divided into three age groups. Results: Of 264 respondents, 73.9% (n = 195) completed AHPD, with half having undergone eye dilation in the past (53.7%, n = 116). The mean task difficulty across all groups was 3.36 ± 1.44 (range: 1 to 5). There were no statistical differences in difficulty between groups. Most caregivers stated that they would consider AHPD in the future (65.8%), and 63% reported that this practice saved time and was worth the cost and difficulty associated with AHPD. For more than 80% of responders, the cost was less than 20 United States Dollars, and 41.8% did not need to pay for their drops. The common reasons for not performing AHPD were difficulty (34.8%, n = 24), cost of the drops (30.4%, n = 21), and unclear instructions (8.7%, n = 6). Conclusions: AHPD can be a useful and cost-effective tool, can offer convenience, and may reduce anxiety in the office. The decision to use this approach should be individualized, considering the child's specific needs, parental comfort and ability, and the nature of the assessed ophthalmologic condition.