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Changes of intraocular pressure and refractive status in children following cycloplegic refraction with 1%

Kuo-Chi Hung1, Hsiu-Mei Huang1, Pei-Wen Lin1

  • 1Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.

Taiwan Journal of Ophthalmology
|October 12, 2017
PubMed

Insights

Cycloplegic mydriasis using cyclopentolate and tropicamide can increase intraocular pressure (IOP) in hyperopic children. Ophthalmologists must carefully monitor IOP in children undergoing cycloplegic eye exams.

Area of Science:

  • Ophthalmology
  • Pediatric Eye Care

Background:

  • Accurate refractive error assessment in children is crucial for timely diagnosis and management of visual impairments.
  • Cycloplegic agents are commonly used to achieve cycloplegia for accurate refraction, but their effect on intraocular pressure (IOP) requires careful consideration, especially in pediatric populations.

Purpose of the Study:

  • To evaluate the impact of cycloplegic mydriasis induced by 1% cyclopentolate and 1% tropicamide on intraocular pressure (IOP) and refractive status in children.
  • To compare IOP and refractive changes between hyperopic and myopic children undergoing cycloplegic refraction.

Main Methods:

  • A retrospective cohort study involving 91 children undergoing cycloplegic mydriasis.
  • Intraocular pressure (IOP) was measured using a noncontact tonometer before and 30 minutes after the administration of 1% cyclopentolate followed by 1% tropicamide.
  • Cycloplegic refraction was performed using an autorefractometer before and after mydriasis.

Main Results:

  • A significant increase in IOP was observed post-cycloplegia (p=0.033), particularly in hyperopic eyes (p=0.008), while myopic eyes showed no significant IOP change (p=0.72).
  • Post-cycloplegic IOP was significantly higher in the hyperopic group compared to the myopic group (p=0.021).
  • A significant hyperopic shift in refraction was noted in all eyes post-cycloplegia (p < 0.0001).

Conclusions:

  • Cycloplegic mydriasis with cyclopentolate and tropicamide can induce significant IOP changes in hyperopic children.
  • Ophthalmologists should exercise caution and monitor IOP closely in pediatric patients using cycloplegic medications, especially those with hyperopia.
Abstract

Keywords:
childrencyclopentolatecycloplegic mydriasisintraocular pressuretropicamide

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