Cycloplegic autorefraction in young adults: is it mandatory?

Abstract

Young hypermetropic adults possessed +1 to +2 D of latent hypermetropia. In contrast, young myopic adults revealed pseudomyopia of -0.5 D. Cycloplegic refraction should be performed in young hypermetropic adults complaining of various signs of asthenopia.

Cycloplegic refraction by 1% cyclopentolate in young adults: is it the gold standard? The Anyang University Students Eye Study (AUSES)

“…However, this was based on a weak cycloplegic regime of 1% tropicamide, compared with the more rigorous cycloplegic regime involving 1% cyclopentolate used in this study, which may explain the differences in results. The difference in SE for those aged 22–39 years was larger in the study of Krantz at 0.44D, quite similar to the values reported by Fotouhi8 and Mimouni 6. A similarly weak cycloplegic regime was used by Krantz et al ,16 but their results were nevertheless similar to those of Fotouhi et al 8 and Mimouni et al 6 and support the need for cycloplegia in young adults.…”

“…After dividing into different refractive groups, the difference in SE was higher for cycloplegic hyperopes (0.65D) than for emmetropes (0.30D) and myopes (0.17D) in the <25 age group. A similar trend was also seen by Mimouni et al 6. They analysed 1400 eyes of 700 participants ageing from 18 to 21 years and showed a larger difference in SE in hyperopes compared with myopes (1.30D vs 0.46D).…”

“…Mimouni et al 6 also discovered that the myopic or hyperopic status remained as a significant predictor of difference in SE in a stepwise multiple regressions in young adults. Obviously, subjects with hyperopia may require more accommodation when focusing at visual target during the measurement than those with myopia, resulting in larger difference in SE after cycloplegia, as is the case in children and adolescents 4.…”

“…All three readings had to be at most 0.50D apart in both the spherical and cylinder components. One per cent cyclopentolate was used to achieve full cycloplegia,6 due to the difficulty of achieving complete cycloplegia in younger subjects with darker irises 4. For each student, one drop of 1% cyclopentolate (Alcon) was administered first, followed by one drop of Mydrin P (Tropicamide 0.5%, phenylephrine HCl 0.5%; Santen Pharmaceutical, Shiga, Japan) and then a second drop of 1% cyclopentolate at 5 min interval between each of the drops 21.…”

Amblyopia and strabismus: trends in prevalence and risk factors among young adults in Israel

“…Second, the fact that the study cohort is from a single geographical area may mean that data cannot be automatically generalised. Third, the use of non-cycloplegic refraction in subjects with a visual acuity of 6/6 may have resulted in 0.5D of overestimation of myopia and underestimation of 1–2D of hyperopia 27. Additionally, while tropicamide 1.0% was routinely used for fundus examinations, cyclopentolate hydrochloride might have facilitated a better peripheral examination, perhaps revealing other explanations for some cases of reduced vision.…”