Cycloplegic Effects on the Cylindrical Components of the Refraction

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Astigmatism management requires accurate refractive error assessment.
• Predicting the need for separate near vision refraction in astigmatic patients is clinically significant.
• Cycloplegic refraction is a key tool for evaluating refractive changes.

Purpose of the Study:

• To compare changes in cylindrical components after cyclopentolate 1% cycloplegia in patients with low versus high astigmatism.
• To determine if near subjective refraction is necessary for precise astigmatic correction in different severity groups.

Main Methods:

• 1014 healthy individuals aged 17-45 with astigmatism (> -0.50 D) were refracted before and after cycloplegia using 1% cyclopentolate.
• Participants were divided into lower astigmatism (-2.25 to -0.50 D) and higher astigmatism (-2.50 D and above) groups.
• Alpines' method was used to analyze differences in refractive components (J0, J45) and axis changes.

Main Results:

• Significant differences in J0 and J45 (wet vs. dry refraction) were observed only in the higher astigmatism group.
• Axis changes after cycloplegia were 3.51 D in the lower astigmatism group and 2.21 D in the higher astigmatism group.
• Age and gender distributions were similar between the low and high astigmatism groups.

Conclusions:

• For lower astigmatism, near subjective refraction aids precise axis determination.
• For higher astigmatism, near subjective refraction may be crucial for accurate power determination.
• Tailoring refraction strategies based on astigmatism severity optimizes patient care.