Atropine eye drops for pre- dilation before an appointment

You have been given Atropine 1% eye drops to be used in your child’s eyes for three days before their next visit. These drops are used to widen the pupil (black central area of the eye) and relax the muscles inside the eye that control the focusing. This will enable us to examine the inside of the eyes and measure whether there is a need for glasses. This information aims to answer any questions you may have. If you are still unsure about anything, please contact the orthoptics department.

When to administer the eye drops

The atropine eye drops will either be given to you in clinic, or they will be posted/couriered to you. They will be individual single dose units. The drops must be given once daily for three days in a row before the next clinic visit, so that your child’s eyes are ready for examination, but not given on the day of the clinic. You will be told by your clinician when to put them in.

You can put the drops in at a convenient time for you, ideally around the same time each day. Some parents and children prefer to use them before bedtime as they can cause blurriness.

How do the drops work?

The drops relax the focus muscles of the eye and relax the muscles of the eye responsible for the pupil (the pupil is the central black area in the middle of the iris which is the coloured part of the eye). 

In the image one eye dilated, that is with a large pupil.

Altropine Eye Drops

How to use the eye drops

Eye drops are not always easy to put in, especially in a child, so please ask the orthoptics or pharmacy team for advice if you feel this may be very difficult. If, for example you have arthritis and difficulties squeezing drops out then we can advise on various eye drop aids to help you with this.

The general principles to put these eye drops in are:

  1. Check the expiry date, to make sure the drop is in date.
  2. Wash your hands before using the eye drop.
  3. Remove one of the single dose drop units from the box.
  4. Twist off the cap from the end of the nozzle.
  5. Either with your child lying down, or in a seated position, tilt their head back so they are looking up. Gently pull the eyelids apart and squeeze one drop into the inside of the lower lid. (If you are unsure if the drop has gone in, then put another drop in).
  6. Repeat with the other eye.
  7. If possible, gently press on the inner corners of your child’s eyelids (next to their nose) for 30-60 seconds to help prevent the drop running into the nose and being swallowed. Do not be worried if you cannot manage doing this.
  8. Discard the eye drop (even though there is likely to be liquid left inside).
  9. Wash your own hands to avoid getting any drops in your own eyes.
  10. Wash your child’s hands to avoid them swallowing any of the eye drop if they rub their eyes and then put their hand in their mouth.

If you have been given ointment instead of drops, you can use it in the same way, putting a small amount of ointment inside the lower lid each time.

What to expect

Please inform your child’s school about the use of the drops, and that your child will have blurred vision and enlarged pupils for at least a week.

Possible side effects

As with all medicines, some side effects may occur. The drops can cause temporary stinging and you may notice that the pupils of the eyes gradually get larger. Your child may also tell you that their vision is blurred. This is due to the relaxation of the focus muscles inside the eye and is completely normal with these drops.

Please read the medicines leaflet you will receive with the drops. Occasionally children can react to atropine, showing raised temperature, hot, dry skin and sickness and rarely palpitations (thumping heart beats), faster or an irregular heartbeat.

If a problem occurs, stop using the atropine immediately and seek advice from your GP or the NHS Helpline 111. If your child is very unwell, immediately seek help by going to your local A&E department.

Sun protection

The drops are likely to make your child’s eyes more sensitive to light, so if it is forecasted to be a sunny day, please prepare with sunglasses or a sun hat to make your child more comfortable and protect their eyes.

Storage of the eye drops

Always keep medicines out of the sight and reach of children.

Store the drops in the original packet in which they were supplied at room temperature and away from direct heat or sunlight.

Important information – please remember:

  • Wash and dry your hands before and after administering the drops.
  • Wash your child’s hands after using the drops.
  • Inform your child’s school about their use of the drops and blurred vision and enlarged pupils.
  • Store the drops in a safe place out of the reach and sight of children.
  • Store the drops in the original packet in which they were supplied at room temperature.
  • Do not use the drops after the expiry date has passed.
  • Do not re-use the single dose unit, discard them once used, even if there is remaining liquid.
  • Tell your pharmacist, orthoptist or doctor if your child is allergic to any medication or if your child has any other eye condition.
  • Should your child have another medical appointment while using atropine, you need to inform other doctors and medical professionals that atropine is being used / has been used within the last 2 weeks of the last drop.
  • Do not use the drops for anyone else.

What if I forget a dose or am unable to put the drops in?

If you forget or are unable to put the drops into your child, please call the orthoptistdepartment for further advice. Contact details are provided below.

Need further advice?

If you need to contact the orthoptics team for any further advice, please either email or telephone the Moorfields service where your child is being seen.

  • Moorfields Eye Hospital, City Road  

Phone: 020 7566 2161 (Monday to Friday)


  • Moorfields at St George’s

Phone: 020 8266 6120 (Monday to Friday)


  • Moorfields at St George’s

Phone: 020 8266 6120 (Monday to Friday)


  • Moorfields at Ealing

Phone: 020 8967 5766 (Tuesday and Wednesday, ask for the orthoptist)

  • Moorfields at Northwick Park

Phone: 020 8869 3160 (Tuesday and Friday, ask for the orthoptist)

  • Moorfields at Homerton

Phone: 020 8510 5018 (Friday, ask for the orthoptist)

  • Moorfields at Potters Bar

Phone: 01707 653 286 (Wednesday)

  • Moorfields at Bedford

Phone: 01234 792 290 (Monday to Friday)

  • Moorfields at Croydon

Phone: 020 8401 3485 (Monday to Friday)



Authors: Alexa Ash, consultant orthoptist, Jayesh Khistria, consultant orthoptist, Julie Broadbent, senior optometrist, Sarah Thomas, advanced specialist pharmacist

Approval date: April 2022

Review date: April 2025