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.
Centre for Vision Research, Department of Ophthalmology, University of Sydney and Westmead Millennium Institute, Westmead Hospital, Westmead, Australia.
Reena
R
Fotedar
Elena
E
Rochtchina
Ian
I
Morgan
Jie Jin
JJ
Wang
Paul
P
Mitchell
Kathryn A
KA
Rose
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