title: Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper.
abstract: OBJECTIVE
  To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens.
  
  
  METHODS
  Twenty-six, young, participants (15F, 25±5 years, range: 18-35 years, SE: +0.25 D and -3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop.
  
  
  RESULTS
  Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p<0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions.
  
  
  CONCLUSIONS
  The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components.
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia. Electronic address: r.bakaraju@brienholdenvision.org.
authors.forename: Ravi Chandra
authors.initials: RC
authors.lastname: Bakaraju
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia.
authors.forename: Cathleen
authors.initials: C
authors.lastname: Fedtke
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, Sydney, Australia.
authors.forename: Klaus
authors.initials: K
authors.lastname: Ehrmann
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia.
authors.forename: Darrin
authors.initials: D
authors.lastname: Falk
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia.
authors.forename: Varghese
authors.initials: V
authors.lastname: Thomas
authors.affiliation: Brien Holden Vision Institute, Sydney, Australia; School of Optometry and Vision Science, Sydney, Australia.
authors.forename: Brien Anthony
authors.initials: BA
authors.lastname: Holden
mesh_terms: D000065:Accommodation, Ocular / Q000187:drug effects / Q000502:physiology*; D000328:Adult; D005139:Eyeglasses; D005260:Female; D006801:Humans; D008297:Male; D009184:Mydriatics / Q000494:pharmacology; D012029:Refraction, Ocular / Q000187:drug effects / Q000502:physiology*; D012683:Sensory Deprivation / Q000502:physiology*; D014331:Tropicamide / Q000494:pharmacology; D014794:Visual Fields / Q000187:drug effects / Q000502:physiology*; D055815:Young Adult
chemical_list: D009184:Mydriatics; D014331:Tropicamide
keywords: Accommodation; Acomodación; Peripheral refraction and higher-order aberrations; Refracción periférica y aberraciones de alto orden