Bausch and Lomb, the manufacturer, said the supply disruption is due to a shortage of the active pharmaceutical ingredient and more should become available mid to late January.
If you have run out of supplies, you may enquire whether other practices near to you have surplus stock that they could supply you to tide you over the next couple of weeks. Alternatively, for low-risk cases, you may wish to consider postponing the cycloplegic refraction for a couple of weeks, reserving your stocks for children at a higher risk of a deviation or amblyopia. Where a cycloplegic refraction is indicated, you should ensure it takes place, but use your professional judgement to determine the best way to achieve this.
The Royal College of Ophthalmologists issued the following advice:
Use multi-dose preserved cyclopentolate eye drops where appropriate. If this is not appropriate, consider tropicamide 1% or phenylephrine 2.5% but be aware that phenylephrine 2.5% is also in short supply.
Consider atropine 1% if there is no other safe alternative. Cyclopentolate hydrochloride must be reserved for cycloplegic refraction.
ENDS