A RANDOMIZED CONTROL TRAIL STUDY OF CYCLOPLEGIC VERSUS NON-CYCLOPLEGIC REFRACTION IN DETECTING HYPEROPIA IN CHILDREN
DOI:
https://doi.org/10.66021/pakmcr937Keywords:
Hyperopia, Cycloplegic refraction, Non-cycloplegic refraction, Pediatric eye examination, Refractive error, pediatric refection, Accommodative error, and cyclopentolate dropAbstract
Background: Hyperopia in children may be underestimated during non-cycloplegic refraction because of strong accommodative ability. Cycloplegic refraction is commonly recommended in pediatric eye examinations; however, its advantage over non-cycloplegic refraction requires further evaluation.
Objective:
To compare spherical equivalent in both cycloplegic and non- cycloplegic auto refraction
To access the degree of hyperopia missed during non-cycloplegic auto refraction.
To compare the accuracy of cycloplegic versus non-cycloplegic auto refraction .
Methodology: This randomized controlled trial included 48 children aged 4–10 years, comprising 29 males and 19 females. Data were collected from DHQ hospital Vehari the patients were randomized by random sampling technique. Each child underwent both non-cycloplegic and cycloplegic auto refraction. Cycloplegia was achieved using tropicamide 1% cycloplegic agent. Tropicamide 1 drop after every 5 minutes was instilled in the patients eye for total duration of 30-45 mints. In 45 mint’s pupil were dilated then checked visual acuity in both eyes. Visual acuity and auto refractometer values of both eyes was accessed before and after usage of drops then compared both visual acuity together for better results. The normality accessed by Shipro-wilk test and data analyzed by SPSS version 27.
Results: Cycloplegic refraction showed significantly higher hyperopic values compared to non-cycloplegic refraction in both eyes. In the right eye, the mean difference was 0.458 diopters (t = 6.306, df = 47, p < 0.001), while in the left eye, the mean difference was 0.375 diopters (t = 4.561, df = 47, p < 0.001). These findings indicate that non-cycloplegic refraction tends to underestimate hyperopia in children.
Conclusion: The study concludes that cycloplegic refraction provides more accurate detection of hyperopia than non-cycloplegic refraction in children aged 4–10 years. Therefore, cycloplegic refraction should be considered an important part of pediatric refractive assessment to avoid underestimation of hyperopia. Early and accurate detection of hyperopia may help in timely management and prevent long-term visual complications in children.
