Comparison of Refraction Data and Visual Acuity With and Without Cyclopentolate in Children and Young Adults

Abstract

Purpose. This investigation compared refraction and visual acuity obtained under cycloplegic and non-cycloplegic condition in a Caucasian population. Material and Methods. One eye of 73 subjects, aged 6-29 years, was examined under cycloplegic (C) and non-cycloplegic (NC) condition using autorefraction (AR), subjective refraction (SR) and visual acuity testing. Subjects were subdivided into refractive groups (emmetropia: −0.5 D < SE < +1.00 D, myopia: SE ≤ −0.5 D, hyperopia: SE ≥ +1.00 D). Results. When comparing AR C and SR NC, deviations in SE were largest in hyperopes (∆SE = 0.74 ± 0.57 D; 95% CI: 0.5 – 0.97 D) compared to emmetropes (∆SE = 0.37 ± 0.21 D; 95% CI: 0.24 – 0.45 D) and myopes (∆SE = 0.25 ± 0.32 D; 95% CI: 0.12 – 0.38 D). When comparing SR C and SR NC, deviations in SE were largest in hyperopes (∆SE = 0.54 ± 0.43 D; 95% CI: 0.36 – 0.71 D) compared to emmetropes (∆SE = 0.23 ± 0.26 D; 95% CI: 0.10 – 0.35 D) and myopes (∆SE = 0.12 ± 0.17 D; 95% CI: 0.04 – 0.18 D). In emmetropes and myopes, C and NC refraction did not change visual acuity. For hyperopes, visual acuity reduced by 0.38 ± 0.18 logMAR and 0.22 ± 0.18 logMAR when comparing AR C prescription and SR C prescription to SR NC prescription, respectively. Conclusion. In emmetropes and myopes, C is not indicated. In hyperopes, C prescription may reduce NC visual acuity. For maximum visual acuity, a combination of C and subjective NC refraction is recommended. C refraction must be performed if visual abnormalities are suspected. Keywords Objective refraction, subjective refraction, visual acuity, cycloplegia, cycloplentolate