Background: Study was conducted to compare efficacy in pupil dilatation between 2% Homatropine(2H) alone and alternate application of 2% Homatropine with 4% Xylocaine(2H/4X) eye drops for easy estimation of refractive error and posterior segment examination. Methods: Over 6 months, after obtaining waiver of consent in 100 eyes of 50 patients age between 5-20years (14.26±3.06), one drop of Xylocaine 4% was applied to left eye ( study eye). After 60 seconds 1 drop of 2% Homatropine was applied in both right (control eye) and left (study eye). Pupil diameter was measured via transparent scale before instillation of first drop. At every 15 minutes interval, pupillary size was measured and subsequent instillations were done, upto one hour. Results: There was a statistical significant difference in pupil diameter between eyes dilated with 2H/4X and 2H alone at 30-60minutes (p<0.001). 31 patients (62%) developed maximum pupillary dilatation of (7.42±0.84) in left eye by 45minutes, while only 4 patients (8%) in right eye. Mean dilatation at 60 minutes in study eye was 7.94±0.24 but in control eye was 7.00±0.83 with p<0.001. Conclusion: Combination of 2H/4X potentiates mydriatic effect produced by Homatropine alone causing quicker onset of action, increases patient comfort level by reducing stinging effect of Homatropine and reducing the chances of side effects of Homatropine like delirium, hallucination, dry mouth by reducing the number of drop instillations. So, combination of 2H/4X can reduce patient’s waiting time in OPD and quicker examination of interior of eye and refractive error with ease.

Keywords: Homatropine; Mydriasis; Xylocaine.