Effect of cycloplegia on refractive errors measured with three different refractometers in school-age children

Authors: CEYHUN ARICI, ADEM TÜRK, SONER KESKİN, OSMAN MELİH CEYLAN, FATİH MEHMET MUTLU, HALİL İBRAHİM ALTINSOY

Abstract: Aim: To compare 3 different refractometers with and without cycloplegia and to examine whether the photorefractometer necessitates cycloplegia in the measurement of refractive errors. Materials and methods: Included in the study were 62 eyes of 31 pediatric patients. The refractive errors of all of the eyes were measured with and without cycloplegia using a table-top autorefractometer (Potec PRK-6000), hand-held autorefractometer (Nidek ARK-30), and photorefractometer (Plusoptix S08), respectively. The spherical power, cylindrical power, cylindrical axis, spherical equivalent, and interpupillary distance values obtained were statistically compared. Results: The average age of the patients was 10.03 ± 2.79 years. There were statistically significant differences between the cycloplegic and noncycloplegic spherical powers and the spherical equivalent values of each device. However, the response to cycloplegia was not significant for the cylindrical values. The Jackson cross-cylinder values at axis 0° and 45° (J0 and J45) of each device similarly was not significantly affected by the cycloplegia. Noncycloplegic spherical equivalent, cylindrical power, and J0 and J45 values measured with the Plusoptix S08 did not have a significant difference from the same values measured with the Potec PRK-6000 for cycloplegia. Conclusion: Accommodation has a prominent effect on the detection of refractive errors of school-age children. The photorefractometer method eliminates the need for cycloplegia in the detection of refractive errors of children from this age group. In the measurements performed with a hand-held autorefractometer, the tendency of myopia as a result of marked accommodation can be seen.

Keywords: Ocular accommodation, child, cyclopentolate, refractometry, refractive errors

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