Necessity of cycloplegia for assessing refractive error in 12-year-old children: a population-based study.
OBJECTIVE
To compare pre- and postcycloplegic autorefraction in two separate age samples of Australian school children.


METHODS
Population-based cross-sectional study of random cluster samples.


METHODS
Autorefraction was performed before and after cycloplegia, using 1% cyclopentolate, in the right eyes of 2,233 12-year-old and 210 6-year-old children.


RESULTS
The mean spherical equivalent (SEQ) difference between these measures was 0.84 diopters (D) (95% confidence interval (CI) 0.81 to 0.87 D), more hyperopic in post- than precycloplegic autorefractive assessments in the 12-year-old children and 1.18 D (95% CI 1.05 to 1.30 D) more hyperopic in the 6-year-old children. Precycloplegic autorefraction substantially overestimated the proportion of children with myopia, misclassifying 17.8% aged 12 years and 9.5% aged 6 years. Conversely, precycloplegic autorefraction did not detect moderate to high hyperopia in 2.28% of 12-year-olds and 17.14% of 6-year-olds.


CONCLUSIONS
Our findings reinforce the importance of using cycloplegic autorefraction in children up to age 12 years.
Fotedar
Reena
R
Centre for Vision Research, Department of Ophthalmology, University of Sydney and Westmead Millennium Institute, Westmead Hospital, Westmead, Australia.
Rochtchina
Elena
E
Morgan
Ian
I
Wang
Jie Jin
JJ
Mitchell
Paul
P
Rose
Kathryn A
KA
D000065:Accommodation, Ocular / Q000502:physiology; D002648:Child; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003519:Cyclopentolate; D003937:Diagnosis, Differential; D006801:Humans; D009184:Mydriatics; D011159:Population Surveillance; D011680:Pupil / Q000187:drug effects*; D012029:Refraction, Ocular / Q000187:drug effects / Q000502:physiology*; D012030:Refractive Errors / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity
D009184:Mydriatics; D003519:Cyclopentolate