Abstract
IntroductionSpectacle non-compliance is a significant problem in pediatric patients, and may have a variety of consequences. Non-compliance with myopic refractive correction could be secondary to a variety of issues, including age, discomfort, gender, urban vs. rural residence, presenting visual acuity, and degree of refractive error. We observed a phenomenon in our pediatric patients with retinopathy of prematurity that may add another possible explanation: incorrect prescription due to measures of increased, rather than decreased, myopia after cycloplegia.Case presentationAn unmasked, prospective study of 8 consecutive patients seen in a single practice. Retinoscopic refraction measurements were obtained before and after pharmacologic cycloplegia.In all 13 eyes, there was either no change (2 eyes) or a myopic shift (11 eyes) in the measured refractive error. The average change in refraction was -1.58 and -1.54 for the right and left eyes, respectively (range 0 to -3.00 OD and 0 to -3.00 OS).ConclusionsThe contribution of ocular components to refractive status differs between ROP and non-ROP eyes. Unanticipated myopic shift following cycloplegia in ROP patients may result in inappropriate glasses prescription with poor correction of visual acuity. This may contribute to spectacle noncompliance in this group.
Highlights
Spectacle non-compliance is a significant problem in pediatric patients, and may have a variety of consequences
The contribution of ocular components to refractive status differs between retinopathy of prematurity (ROP) and non-ROP eyes
In pediatric patients with retinopathy of prematurity (ROP), we found increased rather than
Summary
Spectacle non-compliance is occasionally encountered in pediatric patients [1,2], even though refractive errors may have significant functional, economic, medical, and educational consequences. Non-compliance with myopic refractive correction could be secondary to a variety of issues, including age, discomfort, gender, urban vs rural residence, presenting visual acuity, and degree of refractive error [2,3]. In pediatric patients with retinopathy of prematurity (ROP), we found increased rather than (page number not for citation purposes). Cases Journal 2009, 2:8970 http://jmedicalcasereports.com/jmedicalcasereports/article/view/8970 decreased myopia after cycloplegia. This finding may be of interest to ophthalmologists who care for children with resolved, advanced ROP
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