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Short-term refractive change and ocular parameter changes after cycloplegia.

Han-Chih Cheng1, Yi-Ting Hsieh

  • 1*MD Department of Ophthalmology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei, Taiwan (H.-C.C. and Y.-T.H.); and Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan (Y-TH).

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|July 19, 2014
PubMed
Summary

Tropicamide cycloplegia caused significant positive shifts in refractive error, axial length, and anterior chamber depth in children. Corneal curvature flattened, but these ocular changes did not correlate with refractive shifts.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Pediatric Eye Care

Background:

  • Cycloplegia is essential for accurate refractive error assessment in children.
  • Tropicamide is a commonly used cycloplegic agent.
  • Understanding its short-term effects on ocular parameters is crucial for clinical practice.

Purpose of the Study:

  • To investigate short-term changes in refractive error and ocular parameters following tropicamide-induced cycloplegia.
  • To analyze the correlations between refractive and ocular parameter changes.

Main Methods:

  • Prospective study of 114 children's right eyes.
  • Measurements included spherical equivalent of refractive error (SER), axial length (AL), corneal curvature (CC), and anterior chamber depth (ACD).
  • Measurements were taken before and 30 minutes after 0.4% tropicamide instillation using optical coherence interferometry.

Main Results:

  • Significant positive shifts observed in SER, AL, and ACD post-cycloplegia (p < 0.0001).
  • Corneal curvature (keratometry) decreased significantly (p = 0.005), while corneal astigmatism remained unchanged.
  • Most eyes (72.8%) showed SER changes within ±0.25 D; 24.6% had a hyperopic shift >0.25 D.

Conclusions:

  • Tropicamide induces significant short-term myopic shifts in SER, AL, and ACD in children.
  • Corneal flattening occurs, but astigmatism is unaffected.
  • Refractive changes after tropicamide cycloplegia do not correlate with alterations in AL, ACD, or CC.