Related Experiment Video
Updated: Dec 14, 2025
Comparison of Agreement and Accuracy using Binocular Wavefront Optometer with Autorefractor and Phoropter
Published on: September 16, 2025
Evaluation of the Necessity for Cycloplegia During Refraction of Chinese Children Between 4 and 10 Years Old
Insights
Cycloplegia using atropine is essential for accurate refractive error assessment in children aged 4-10. This method prevents overestimation of myopia, ensuring correct prescription of glasses, particularly for those with high myopia.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Refractive Error Assessment
Background:
- Accurate refractive error assessment in children is crucial for timely intervention and appropriate prescription of corrective lenses.
- Cycloplegia, a state of paralysis of the ciliary muscle, is often employed to relax accommodation and reveal the true refractive state.
- The necessity and impact of cycloplegia in pediatric populations with varying refractive errors require continued investigation.
Purpose of the Study:
- To investigate the influence of atropine cycloplegia on the refractive status of children aged 4 to 10 years.
- To evaluate the necessity of cycloplegia for accurate refractive correction across different age groups and refractive error categories.
Main Methods:
- A retrospective analysis of 11,795 children (aged 4-10) with myopia or hyperopia.
- Patients were categorized into two age groups: 4-6 years and 7-10 years.
- Cycloplegia was induced using atropine sulfate, and refractive errors were measured via retinoscopy.
Main Results:
- Significant differences were observed between cycloplegic and non-cycloplegic refractive error measurements (DIFFC-N) in all pediatric groups.
- DIFFC-N showed a negative correlation with age, indicating less accommodative influence in older children.
- The discrepancy between prescribed glasses and non-cycloplegic refraction (DIFFG-N) was most pronounced in children with high myopia.
Conclusions:
- Autorefraction without cycloplegia tends to overestimate refractive error in myopic children.
- Cycloplegia is recommended for accurate refractive error assessment and glasses prescription in children aged 4-10.
- The use of cycloplegia is particularly critical for children diagnosed with high myopia.
Purpose:
To determine the effect of atropine cycloplegia on the refractive status of children aged 4 to 10 years and to evaluate the necessity of cycloplegia for different refractive states and ages during refractive correction.
Methods:
This retrospective study included patients with low, moderate, and high myopia and hyperopia who were divided into two groups by age: 4 to 6 years (n = 5,320) and 7 to 10 years (n = 6,475). Every patient underwent cycloplegia with atropine sulphate. Refractive errors were measured by retinoscopy.
Results:
Within each group, the differences between cycloplegic and non-cycloplegic refractive errors (DIFFC-N) were significant. DIFFC-N was negatively correlated with age (r = -0.356, P < .001). The differences in refractive error between prescribed glasses and non-cycloplegic refraction (DIFFG-N) were largest in the groups with high myopia (0.83 ± 1.15 diopters [D] in the 4 to 6 years group and 0.60 ± 1.47 D in the 7 to 10 years group). After cycloplegia, 62.5% of the patients with mild myopia became emmetropic or hyperopic in the 4 to 6 years group, and 11.3% of the patients with mild myopia became emmetropic or hyperopic in the 7 to 10 years group.
Conclusions:
Without cycloplegia, autorefraction tends to overestimate refractive error in children with myopia. For accurate glasses prescriptions, cycloplegia should be used for children between 4 and 10 years, especially for children with high myopia. [J Pediatr Ophthalmol Strabismus. 2020;57(4):257-263.].
More Related Videos
Related Concept Videos
01:16Focusing of Light in the Eye
01:17Accessory Structures of the Eye