Why ‘automated computerized refraction’ just isn’t enough?

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A COUPLE of months ago a 9-year-old boy came with his parents to our practice to have his eyes examined. He was complaining that his vision at the distance was blurred and that his eyes felt strained. The boy has been doing a lot of work at close range. He was reading a lot during the weekdays and spending a lot of time in front of the computer and playing with his iPad during the weekends. On examination I was getting inconsistent responses from him. He was able to see 20/20 however the results from the automated computer refraction showed he had a significant amount of nearsightedness.

Because of this inconsistency and the false nearsightedness I was getting from the automated computer, I had to perform cycloplegic refraction. In doing so, my patient ended up not even needing a pair of eyeglasses after all.

Our patient is one of many patients, mainly children, who will benefit from such an eye examination. The term “cycloplegic refraction” certainly sounds intimidating. Tell this to a child and it can be understandably frightening. As with many unknowns, a little knowledge and setting expectations can take away unnecessary fears.

What is cycloplegic refraction?

Cycloplegic refraction is nothing more than a procedure used by eye doctors to gain an accurate reading of a person’s refractive error to help him/her see more clearly and comfortably.

Cycloplegic refraction temporarily stops the eye’s ability to autofocus, allowing your eye doctor to correctly ascertain your prescription and optimize your ability to see clearly and comfortably.

Why is cycloplegic refraction common with children?

Cycloplegic refraction is oftentimes used with children. Children have a strong ability to unknowingly accommodate or autofocus their vision that makes eye exams yield inaccurate or incomplete results. As described above, cycloplegic refraction briefly suspends a child’s ability to autofocus. This provides the eye doctor with an uninterrupted opportunity to obtain an exact reading on the child’s refractive error and derive a true and accurate prescription.

What to expect in cycloplegic refraction

Cycloplegic eye drops are placed in the patient’s eye to prevent the ciliary muscle of the eye from contracting and relaxing. This muscle is attached to the crystalline lens of the eye and controls the shape of lens.

There are a variety of cycloplegic eye drops that differ in strength and duration. When these eye drops are applied, it causes the pupils to dilate and vision will become blurred for a few hours. Some patients also experience tearing and redness in the eyes.

Not just for children

Cycloplegic refraction is not exclusively for children. It may be done in adults prior to refractive surgery to ensure the manifest refraction is correct. At times the procedure is performed to gain a more precise and refined eyeglass prescription especially if eyeglasses do not provide the level of clarity needed.

(The practice of cycloplegic refraction is now available at George Optical. The author is the president and professional services manager of George Optical. He was chosen as the 2012 Outstanding Professional of the Year in the field of optometry given by the Professional Regulation Commission. You may send in your comments and feedback to info@george-optical.com)

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