[Effect of cycloplegic agents on the course of myopia].
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Adolescent↗
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A non-cycloplegic refraction technique for infants and young children.
An objective, near-retinoscopy technique for assessing non-cyloplegic refractions in infants and young children is presented. The technique involves performing retinoscopy at near in an otherwise dark room, as the patient fixates the retinoscope light with one eye, while the other is occluded. Data are presented which support the reliability and validity of this technique in adults and infants.
Age Factors↗
[Evaluation of cycloplegic drugs based on results of refractometry].
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Accommodation, Ocular↗
[Cycloplegic action of amisyl].
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Accommodation, Ocular↗
Screening for refractive errors in children: accuracy of the hand held refractor Retinomax to screen for astigmatism.
AIMS: To assess the reliability of the hand held automated refractor Retinomax in measuring astigmatism in non-cycloplegic conditions. To assess the accuracy of Retinomax in diagnosing abnormal astigmatism in non-cycloplegic refractive screening of children between 9 and 36 months. METHODS: Among 1205 children undergoing a non-cycloplegic refractive screening with Retinomax, 299 (25%) had repeated non-cycloplegic measurements, 302 (25%) were refracted under cycloplegia using the same refractor, and 88 (7%) using retinoscopy or an automated on table refractor. The reproducibility of non-cycloplegic cylinder measurement was assessed by comparing the cylindrical power and axis values in the 299 repeated measurements without cycloplegia. The influence of the quick mode on cylinder measurement was analysed by comparing the cylinder and axis value in 93 repeated measurements without cycloplegia where normal mode was used in one measurement and quick mode in the other. Predictive values of the refractive screening were calculated for three different thresholds of manifest astigmatism (> or = 1.5, > or = 1.75, and > or = 2 D) considering as a true positive case an astigmatism > or = 2 D under cycloplegic condition (measured by retinoscopy, on table, or hand held refractor). RESULTS: The 95% limits of agreement between two repeated manifest cylinder measurements with Retinomax attained levels slightly less than plus or minus 1 D. The 95% limits of agreement for the axis were plus or minus 46 degrees. The comparison of non-cycloplegic measurements in the quick and normal mode showed no significant difference and 95% limits of agreement plus or minus 0.75 D. The mean difference between non-cycloplegic and cycloplegic cylinder values measured by Retinomax reached 0.17 D and was statistically significant. Manifest thresholds of > or = 1.5 D, > or = 1.75 D, > or = 2 D cylinder value diagnosed 2 D of astigmatism under cyclplegia respectively with 71-84%, 59-80%, 51-54% of sensitivity (right eye-left eye) and 90-92%, 95%, 98% of specificity. CONCLUSION: Without cycloplegia, Retinomax is able to measure cylinder power with the same reproducibility as cycloplegic retinoscopy. No significant difference was found in the cylinder values obtained with the quick and the normal modes. Therefore, the quick mode of measurement is recommended as it is more feasible in children. No difference, which is significant from a screening point of view, exists between the non-cycloplegic and the cycloplegic cylinder value (< 0.25 D). Retinomax diagnoses abnormal astigmatism (> or = 2 D) in a non-cycloplegic refractive screening at preschool ages with 51-84% sensitivity rates and 98-90% specificity rates, depending on the chosen threshold of manifest astigmatism. If 2 D of manifest astigmatism is chosen as a positive test, the positive predictive value of the screening reaches 81-84% and the negative predictive value 91-90% (right eye-left eye).
Age Distribution↗
Comparison of the techniques of videorefraction and static retinoscopy in the measurement of refractive error in infants.
Photorefraction has been suggested as a suitable method of screening for refractive error in infants. The relative performance of cycloplegic and non-cycloplegic videorefraction and cycloplegic retinoscopy was investigated on 150 infants. Under cycloplegic conditions the correlation between findings for spherical error (Rxy = 0.70) was compatible with a previous study. However, where cycloplegia was not used for videorefraction, there was poor agreement between the two techniques in the case of astigmatic error, and all types of ametropia. Interobserver repeatability was very high both for cycloplegic retinoscopy (Rxy = 0.96 spherical error, and Rxy = 0.75 astigmatic error) and for videorefraction measurements (Rxy = 0.95 horizontal meridian of photograph and Rxy = 0.85 vertical meridian). Intraobserver repeatability was also good, both for cycloplegic retinoscopy (Rxy = 0.91 spherical error and 0.82 astigmatic error) and for videorefraction with regard to spherical errors (Rxy = 0.84). Throughout the experiments videorefraction measurements of astigmatic errors proved less consistent when compared with cycloplegic retinoscopy, and to its internal reliability.
Astigmatism↗
The influence of cycloplegia in objective refraction.
The purpose of this study was to compare refractions measured with an autorefractor and by retinoscopy with and without cycloplegia. The objective refractions were performed in 199 right eyes from 199 healthy young adults with a mean age of 21.6 +/- 2.66 years. The measurements were performed first without cycloplegia and repeated 30 min later with cycloplegia. Data were analysed using Fourier decomposition of the power profile. More negative values of component M and J(0) were given by non-cycloplegic autorefraction compared with cycloplegic autorefraction (p < 0.0001). However more positive values for the J(45) vector were given by non-cycloplegic autorefraction, although this difference was not statistically significant (p = 0.233). By retinoscopy, more negative values of component M were obtained with non-cycloplegic retinoscopy (p < 0.0001); for the cylindrical vectors J(0) and J(45) the retinoscopy without cycloplegia yields more negative values (p = 0.234; p = 0.112, respectively). Accepting that differences between cycloplegic and non-cycloplegic retinoscopy are only due to the accommodative response, the present results confirm that when performed by an experienced clinician, retinoscopy is a more reliable method to obtain the objective starting point for refraction under non-cycloplegic conditions.
Accommodation, Ocular↗
Repeatability and validity of Zywave aberrometer measurements.
PURPOSE: To study the repeatability of Zywave aberrometer (Bausch & Lomb) measurements and compare the measurements with those of subjective refraction and noncycloplegic and cycloplegic autorefractions in a clinical setting. SETTING: Department of Ophthalmology, University Hospital Maastricht, Maastricht, The Netherlands. METHODS: Subjective manifest refraction, noncycloplegic autorefraction, cycloplegic autorefraction, and Zywave aberrometer measurements were performed in 20 eyes of 20 myopic patients. Three consecutive Zywave measurements were performed with and without dilation of the pupil. The mean difference and 95% limits of agreement among the measurement methods were determined for dilated and 3.5 mm pupils. The repeatability coefficient of the Zywave aberrometer measurements was determined. RESULTS: The mean differences in spherical equivalent (SE), sphere, and cylinder between subjective refraction and Zywave predicted phoropter refraction (PPR) with a dilated pupil were -1.10 diopters (D) +/- 0.46 (SD) (P <.001), -1.08 +/- 0.44 D (P <.001), and -0.02 +/- 0.37 D (P =.87), respectively (paired Student t test). After the data were converted to a 3.5 mm pupil, the mean differences were -0.55 +/- 0.48 D (P <.001), -0.50 +/- 0.49 D (P <.001), and -0.16 +/- 0.50 D (P =.15), respectively. The mean difference in SE between autorefraction and cycloplegic autorefraction versus subjective refraction was +0.18 +/- 0.71 D (P =.27) and +0.35 +/- 0.62 D (P =.02), respectively. The mean difference in SE between cycloplegic autorefraction and Zywave PPR with a dilated pupil was -1.44 +/- 0.79 D (P <.001). The repeatability coefficient of Zywave PPR was +/-0.25 D for SE, +/-0.29 D for sphere, and +/-0.29 D for cylinder. CONCLUSIONS: Subjective refraction measurements are slightly more myopic than cycloplegic autorefraction measurements. With a dilated pupil, the Zywave measurements were significantly more myopic than subjective refractions and even more myopic than cycloplegic autorefractions. Zywave measurements and subjective refractions were in better agreement with a 3.5 mm pupil. The repeatability of Zywave aberrometer measurements is adequate for lower-order aberrations.
Adolescent↗
Myopia control trial with progressive addition lenses in Japanese schoolchildren: baseline measures of refraction, accommodation, and heterophoria.
PURPOSE: To describe baseline measures of refraction, accommodation, and heterophoria in Japanese schoolchildren enrolled in a randomized clinical trial that examines whether progressive addition lenses slow myopic progression compared with single-focus lenses. METHODS: Ninety-five children with myopia between -1.25 and -6.00 D spherical equivalent were recruited. Their ages ranged from 6 to 12 years; 46% were girls. The main outcome measure for the trial was progression of myopia determined by cycloplegic (0.5% tropicamide) autorefraction. Accommodative lags and heterophoria were also evaluated. RESULTS: Because data were similar in both eyes, they are reported for the right eye only. The mean (+/-SD) cycloplegic autorefraction (spherical equivalent) was -3.22 +/- 1.22 D. The cycloplegic subjective refraction was larger (less myopic) than the noncycloplegic subjective refraction by 0.25 +/- 0.22 D. The mean distance prescription was larger (undercorrection) than the mean cycloplegic autorefraction by 0.74 +/- 0.37 D. The mean accommodative lag for a 4.74 D target was 2.05 +/- 0.98 D. Near-point esophoria was found in 29 (31%) of the children when their refractive errors were fully corrected with glasses. CONCLUSIONS: The measurements reported herein will serve as a basis for assessing changes that occur over a 3-year follow-up period. Compared with the baseline measurements in the Correction of Myopia Evaluation Trial, clear differences were observed in the mean cycloplegic autorefraction and distance prescriptions. The accommodation and heterophoria data showed characteristics similar to those recently reported in myopic children abroad.
Accommodation, Ocular↗
Anterior nongranulomatous uveitis after intravitreal HPMPC (cidofovir) for the treatment of cytomegalovirus retinitis. Analysis and prevention.
BACKGROUND AND OBJECTIVE: The authors characterize and analyze the incidence of a previously reported mild anterior nongranulomatous uveitis associated with intravitreal injections of (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl)cytosine (HPMPC), also termed cidofovir (Vistide, Gilead Sciences, Foster City, CA). This is an acyclic nucleoside phosphonate analogue with a potent anticytomegalovirus effect. The authors also analyzed the effects of probenecid therapy, as well as prophylaxis with probenecid plus topical corticosteroids and cycloplegics on the course and outcome of the uveitis. METHODS: Prospective case series from a tertiary referral center, which included 46 consecutive patients with acquired immune deficiency syndrome (AIDS) and cytomegalovirus (CMV) retinitis. There was a total of 130 injections in 69 eyes treated with 20 micrograms of intravitreal HPMPC. Forty-one patients (119 injections) received oral probenecid, 5 patients (11 injections) did not, and 21 patients (53 injections) received topical corticosteroids and cycloplegics as an adjuvant to probenecid in the prophylaxis of iritis. RESULTS: Mild to moderate nongranulomatous iritis was seen in 26% of patients after their first injection (n = 12). Patients receiving probenecid prophylaxis after first injection had a significantly lower frequency of iritis versus patients who did not receive probenecid at the time of first injection (P = 0.0089). In contrast, treatment with topical corticosteroid and cycloplegics after injection did not statistically significantly affect the frequency of iritis in patients (P = 0.44). The development of iritis after a second injection of HPMPC was more likely if it had occurred after the initial injection (P = 0.015; Fisher's exact test). All cases of iritis were treated with topical corticosteroids and cycloplegics, and there was no permanent impairment of vision secondary to iritis after HPMPC injection in any eyes. CONCLUSIONS: Anterior uveitis was seen in 26% of patients after first-time HPMPC injection. Concomitant use of probenecid appears to decrease the frequency of the iritis from 71% to 18% in patients with AIDS and CMV retinitis after the first intravitreal injection of HPMPC. Topical corticosteroid administration after injection (before iritis) was ineffective in preventing iritis treatment with topical corticosteroids and cycloplegics resulted in resolution of all iritis cases.
AIDS-Related Opportunistic Infections↗
Repeatability and validity of astigmatism measurements.
BACKGROUND: As more patients inquire about refractive surgical procedures, the measurement of astigmatism prior to surgery becomes more important in assessing refractive outcome. Knowledge of the repeatability of the astigmatism measurement allows one to distinguish a true change in cylinder power from measurement error. METHODS: Forty adults with structurally normal eyes and refractive errors were evaluated for the repeatability of astigmatic refractive error measures. Noncycloplegic and cycloplegic measurements of refractive astigmatism were made by retinoscopy, subjective refraction, and autorefraction. All measures were made at 2 visits within 2 weeks by the same examiner. Difference versus mean plots and the 95% limits of agreement of each technique determined the repeatability of a measurement and the agreement between the methods of measurement. RESULTS: The most reliable measure of astigmatic refractive error was cycloplegic autorefraction, with 95% limits of agreement of +/- 0.28 D, followed by noncycloplegic autorefraction (+/- 0.35 D) and cycloplegic subjective refraction (+/- 0.44 D). Noncycloplegic retinoscopy was the least reliable astigmatic refractive error measure, with interoccasion 95% limits of agreement of +/- 1.02 D. The most repeatable measurement of cylinder axis was cycloplegic autorefraction; none of the measurements differed by 10 degrees or more. The least repeatable measurement was noncycloplegic retinoscopy; 40% of the measurements differed by 10 degrees or more. CONCLUSION: For studies seeking to measure changes in astigmatism in normal eyes, cycloplegic autorefraction is the method of choice.
Adult↗
Stability of refraction and visual acuity during 5 years in eyes with simple myopia. The PERK Study Group.
BACKGROUND: Normal ranges of variability of refraction and visual acuity in adult myopic eyes are needed as a reference standard for assessing the stability of refractive corneal surgery. METHODS: We measured the changes in spectacle-corrected visual acuity and cycloplegic refraction during 5 years for the unoperated eye of 82 patients aged 21 to 57 years in the Prospective Evaluation of Radial Keratotomy Study. The changes were compared for contact lens and non-contact lens wearers. We also compared the 5-year cycloplegic and manifest refractions for these unoperated eyes. RESULTS: Of 77 eyes, 44% gained or lost one Snellen line and 48% experienced no change in spectacle-corrected visual acuity between baseline and 5 years. Only one eye (1%) lost two lines, and 7% gained two lines. The refractive change was less than 1.00 D for 84% of the 37 non-contact lens wearing eyes. Only 13% became more myopic by at least 1.00 D (maximum increase in myopia, 2.00 D), and 3% became less myopic by 1.00 D. Of 45 contact lens wearing eyes, 38% became more myopic by at least 1.00 D. The 5-year manifest refraction was 0.50 D to 1.50 D more myopic than the cycloplegic refraction for 37% of eyes. CONCLUSIONS: We recommend using two or more Snellen lines as the standard for a meaningful change in spectacle-corrected visual acuity in operated eyes, and 1.00 D as a meaningful cutoff for stability of refraction. The wearing of contact lenses can confound the results of stability studies. The difference between the cycloplegic and manifest refractions suggests that the cycloplegic refraction should be used in planning for refractive surgery.
Adult↗
Wavefront analysis in post-LASIK eyes and its correlation with visual symptoms, refraction, and topography.
PURPOSE: To evaluate the information assessed with the LADARWave wavefront measurement device and correlate it with visual symptoms, refraction, and corneal topography in previously LASIK-treated eyes. PARTICIPANTS: One hundred five eyes (58 patients) of individuals who underwent LASIK surgery were evaluated. DESIGN: Retrospective, noncomparative case series. MAIN OUTCOME MEASURES: Complete ophthalmologic examination, corneal topography, and wavefront measurements were performed. Correlations were made between the examinations and symptoms. METHODS: Wavefront measurements were assessed with the LADARWave device. Manifest, cycloplegic refraction, and topographic data were compared with wavefront refraction and higher order aberrations. Visual symptoms were correlated to higher order aberrations in 3 different pupil sizes (5-mm, 7-mm, and scotopic pupil size). Pearson's correlation coefficient and generalized estimating equations were used for statistical analysis. RESULTS: In post-LASIK eyes, wavefront refraction components were poorly correlated to manifest and cycloplegic components. The comparison between manifest, cycloplegic, and wavefront refraction with total amount of higher order aberrations showed no strong correlation. The comparison between topography and manifest, cycloplegic, and wavefront refraction did not show strong correlation. Visual symptoms analysis showed correlation of double vision with total coma and with horizontal coma for the 5-mm and 7-mm pupil size; correlation between starburst and total coma for the 7-mm pupil size; and correlation of double vision with horizontal coma, glare with spherical aberrations and with total aberrations, and starburst with spherical aberrations for the scotopic pupil size. Scotopic pupil size had a positive association with starburst and a negative association with double vision. CONCLUSIONS: The LADARWave wavefront measurement device is a valuable diagnostic tool in measuring refractive error with ocular aberrations in post-LASIK eyes. A strong correlation between visual symptoms and ocular aberrations, such as monocular diplopia with coma and starburst and glare with spherical aberration, suggest this device is valuable in diagnosing symptomatic LASIK-induced aberrations. Horizontal coma was correlated with double vision, whereas vertical coma was not.
Adult↗
Radial and staggered treatment patterns to correct hyperopia using noncontact holmium:YAG laser thermal keratoplasty.
PURPOSE: To compare the effects of two treatment patterns in the correction of hyperopia by noncontact holmium:YAG laser thermal keratoplasty (LTK). SETTING: Divisione Oculistica, Ospedale S. Gerardo, Monza, Italy. METHODS: Using two treatment patterns, we performed noncontact LTK in one session in 16 eyes of 8 patients with isometropic hyperopic refractive errors; mean preoperative subjective cycloplegic refraction was +4.90 diopters (D) +/- 1.17 (SD). The treatment consisted of 24 spots in three concentric rings of eight spots each; ring diameters were 6.0, 7.0, and 8.0 mm, respectively. Each spot received seven pulses of laser energy at 30 mJ/pulse. We treated one eye of each patient with a radial pattern (the spots of the three rings aligned on the eight semimeridians) and the fellow eye with a staggered pattern (the spots of the contiguous rings at 22.5 degrees from each other). Follow-up at 1, 15, 30, 90, 180, and 360 days included subjective cycloplegic refraction, uncorrected (UCVA) and spectacle-corrected visual acuity (SCVA), computerized videokeratography (CVK), and Scheimpflug camera examination. RESULTS: One year postoperatively, the mean subjective cycloplegic refraction was +2.75 +/- 1.6 D in the eyes treated with the radial pattern and +3.40 +/- 1.6 D in those treated with the staggered pattern; the mean change in subjective cycloplegic refraction was 2.15 and 1.50 D, respectively. Mean UCVA improved by five lines in the radial group and by four lines in the staggered group. Mean SCVA returned to preoperative levels by day 15 in the radial group and at 1 year in the staggered group; at 1 year, SCVA improved by one line in the radial group and remained unchanged in the staggered group. No eye lost one or more lines of SCVA. Refractive astigmatism was essentially unchanged in both groups. Scheimpflug photography and CVK indicated larger and more uniform corrected zones in the radial group. CONCLUSIONS: Radial and staggered patterns effectively corrected low hyperopia, although both were subject to a certain amount of regression. The radial pattern produced faster postoperative recovery of SCVA and demonstrated greater refractive stability.
Adult↗
Clinical evaluation of an eccentric infrared photorefractor: the PowerRefractor.
PURPOSE: To evaluate the viability of the PowerRefractor as a screening tool for examining refractive errors in large samples of children. METHODS: The variability of the PowerRefractor was estimated using four patients. The refractive error was determined using cyclopentolate and tropicamide as cycloplegic agents and compared to that determined in a non-cycloplegic situation. In a second study, the data provided by the PowerRefractor were compared to results obtained by autorefractor or retinoscopy for 150 children aged from 6 months to 5 years. RESULTS: Variability study. Statistical analysis showed a statistically significant difference between cycloplegic and non-cycloplegic refraction for spherical and cylindrical refractive errors (p<0.0001 in all cases). There was no significant difference between the measurements made using tropicamide and cyclopentolate (p=0.33 and p=0.18, respectively). Comparison study. In 142 of 150 patients the difference between data obtained by the PowerRefractor and an autorefractor was within 1 D (spherical equivalent). However, there was a considerable difference between the data generated by the two methods in the remaining eight patients (up to 16 D). CONCLUSIONS: The PowerRefractor proved to be a reliable tool for estimating refractive errors in young children. The apparatus is easy to handle and the simultaneous examination of both eyes makes the PowerRefractor ideal for obtaining data on refractive errors in large samples.
Adolescent↗
Hyperopic laser in situ keratomileusis: primary and secondary treatments are safe and effective.
PURPOSE: To retrospectively analyze the safety and efficacy of hyperopic laser in situ keratomileusis (LASIK) treatment of eyes with primary hyperopia and consecutive hyperopia after initial myopic treatment. METHODS: Thirty-two eyes of 19 patients with primary hyperopia (group 1) and 37 eyes of 26 patients with consecutive hyperopia after initial myopic LASIK overcorrection (group 2) that had LASIK for hyperopia with the Hansatome microkeratome and VISX S2 Smoothscan excimer laser with 6 months' follow-up after surgery were analyzed. Uncorrected visual acuity, best spectacle-corrected visual acuity, fogged manifest refraction, and corneal topography with corneal irregularity measurement (CIM) were evaluated 1 month, 3 months, and 6 months after surgery. RESULTS: In group 1, the mean preoperative cycloplegic spherical equivalent was +4.0 +/- 4.5 diopters (D) (range, +1.5 to + 8.75 D) and the 6-month postoperative cycloplegic spherical equivalent was +0.26 +/- 1.74 D (range, -3.00 to +2.75 D). Fifty-three percent of eyes (n= 17) in group 1 were within 1 D of emmetropia. Sixty-six percent of eyes (n= 21) had uncorrected visual acuity of at least 20/40. Three eyes (9%) lost two lines of best spectacle-corrected visual acuity. Changes in uncorrected visual acuity, best spectacle-corrected visual acuity, spherical equivalent, and the CIM topographic index 6 months after surgery were statistically significant compared with the preoperative values. In group 2, the mean preoperative cycloplegic spherical equivalent was +1.58 +/- 0.35 D (range, +0.125 to +2.75 D), and the mean postoperative cycloplegic spherical equivalent was -0.48 +/- 0.46 (range, -2.75 to +0.38 D). Eighty-six percent of eyes (n= 32) were within 1 D of emmetropia. Eighty-four percent of eyes (n= 31) in group 2 had uncorrected visual acuity of at least 20/40. One eye (2.7%) lost two lines of best spectacle-corrected visual acuity. Complications included an epithelial nest that resolved 3 months after surgery in one eye in group 2. CONCLUSIONS: LASIK is a relatively safe treatment of primary hyperopia and hyperopia resulting from overcorrection after initial LASIK treatment of myopia (consecutive hyperopia). Patients with high hyperopia (>5 D) are at risk for loss of two lines of best spectacle-corrected visual acuity. A reduction in the level of attempted correction appears to be necessary in the treatment of consecutive hyperopia.
Adult↗
Comparison of refraction obtained by "near retinoscopy" and retinoscopy under cycloplegia.
This study compared refractive error obtained by the "near retinoscopy" method as described by Mohindra and static retinoscopy under cycloplegic conditions. Twenty-two patients between the age of 3.6 and 10.0 years were objectively refracted. The examiner performed a near retinoscopy on each patient. Immediately after this procedure, 2 drops of 1% Cyclogyl (cyclopentolate) were administered to each eye, 5 min apart. Cycloplegic retinoscopy was performed 35 to 40 min after the 2nd drop was administered. In order to reduce examiner bias, the specific powers of the neutralizing lenses were unknown to the examiner throughout the entire procedure. On average, retinoscopy under cycloplegic conditions revealed +0.50 to +0.75 D more plus than near retinoscopy. Although the Student's t-test indicated the values were significantly different on an absolute basis, a Pearson's r of +0.85 was found when all meridians were compared. In addition, if a "cut" factor is introduced to adjust for normal accommodative tonus eliminated under cycloplegic conditions, the two procedures produce essentially the same results.
Child↗
Comparison of cyclopentolate versus tropicamide cycloplegia in children.
This double masked study compares the cycloplegic effects of tropicamide 1% and cyclopentolate 1% in 20 nonstrabismic, nonamblyopic, hyperopic 6- to 12-year-old children with a mean refractive error = +1.48 +/- 1.10 diopters (D). Unlike previous studies which used only amplitude of accommodation to measure the depth of cycloplegia, this study compares refractive error as determined by retinoscopy, distance subjective refraction, and distance autorefraction (Canon R-1). In addition, we compare the amplitude of accommodation as measured by subjective push-up and objective autorefraction methods. There is no statistically significant difference between cyclopentolate and tropicamide for either cycloplegic retinoscopy or distance subjective refraction. Autorefraction measurement of refractive error shows a statistically significant but clinically unimportant bias (0.14 +/- 0.30 D) toward more hyperopia with cyclopentolate. Both drops reveal latent hyperopia, and the mean latencies are not statistically different between the two cycloplegic agents. Latent hyperopia is not systematically related to the degree of hyperopia after tropicamide, but this relation is significant after cyclopentolate. No differences were found between refractive results with either agent at 30 min compared to 60 min after drop instillation. When measured objectively with the autorefractor, accommodation is inhibited more effectively by cyclopentolate than by tropicamide. Our results suggest that although tropicamide is not as effective as cyclopentolate in inhibiting accommodation it is, nevertheless, a useful cycloplegic agent for measuring distance refractive error of low to moderate hyperopia in school-aged children.
Accommodation, Ocular↗