title: Cycloplegic autorefraction in young adults: is it mandatory?
abstract: OBJECTIVE
  The precise correction of refractive error is especially important in young adults. It is unclear whether cycloplegic refraction is necessary in this age group. The purpose of this study was to compare the non-cycloplegic and cycloplegic spherical equivalent (SE) refractive error measured in young adults.
  
  
  METHODS
  This was a prospective study of 1400 eyes (n = 700) of enlisted soldiers aged 18 to 21 years who were consecutively evaluated in an outpatient army ophthalmology clinic. One drop of cyclopentolate 1 % was installed twice 10 min apart, and cycloplegic refraction was performed in both eyes 40 min later using an auto-refractor. The difference between non-cycloplegic and cycloplegic refractive measurements was analyzed.
  
  
  RESULTS
  The mean difference in SE between non-cycloplegic and cycloplegic measurements was 0.68 ± 0.83 D (95 % CI, 0.64-0.72). Significantly greater differences were observed in hypermetropes than myopes (1.30 ± 0.90 D versus 0.46 ± 0.68 D, p < 0.001). Moderate hypermetropes (2 to 5 D) demonstrated significantly greater refractive error than mild (0.5 to 2 D) or severe (>5 D) hypermetropes (1.71 ± 1.18 D versus 1.19 ± 0.74 D and 1.16 ± 1.08 D respectively, p < 0.001).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology, Rambam Health Care Campus, P.O.B. 9602, Haifa, Israel, 31096. m_mimouni@rambam.health.gov.il.
authors.forename: Michael
authors.initials: M
authors.lastname: Mimouni
authors.affiliation: Maccabi Health Service, Haifa, Israel.
authors.forename: Lilach
authors.initials: L
authors.lastname: Zoller
authors.affiliation: Carmel Medical Center, Haifa, Israel.
authors.forename: Josefa
authors.initials: J
authors.lastname: Horowitz
authors.affiliation: Goldschleger Eye Institute, Sheba Medical Center, Tel-Hashomer, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
authors.forename: Tamara
authors.initials: T
authors.lastname: Wygnanski-Jaffe
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.|Assaf-Harofeh Medical Center, Tel Aviv, Israel.
authors.forename: Yair
authors.initials: Y
authors.lastname: Morad
authors.affiliation: Department of Ophthalmology, Rambam Health Care Campus, P.O.B. 9602, Haifa, Israel, 31096.|The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
authors.forename: Eedy
authors.initials: E
authors.lastname: Mezer
mesh_terms: D000293:Adolescent; D003519:Cyclopentolate / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008889:Military Personnel; D009184:Mydriatics / Q000008:administration & dosage*; D009216:Myopia / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D011680:Pupil / Q000187:drug effects; D012029:Refraction, Ocular / Q000502:physiology*; D042262:Retinoscopy; D055815:Young Adult
chemical_list: D009184:Mydriatics; D003519:Cyclopentolate
keywords: Adults; Cycloplegic; Refraction; Young