Optimal dosage of cyclopentolate 1% for cycloplegic refraction in hypermetropes with brown irides.

To find the optimal dosage of cyclopentolate 1% for cycloplegic refraction in hypermetropes with brown irides, we investigated the difference in cycloplegic auto-refractions obtained after one, two, and three instillations in the same patient. The mean hypermetropia found after three instillations was statistically significantly more compared to that found after one instillation. There was no statistically significant difference in the mean hypermetropia between two and three instillations. There was no significant effect of gender, age, and the presence and type of horizontal deviation. These observations suggest that two drops of cyclopentolate 1% 10 min apart are sufficient for cycloplegic refraction in hypermetropes.

Use of atropine to predict the accommodative component in esotropia with hypermetropia.

This cohort study included children with esotropia and hypermetropia of ≥ +2.0 diopters (D). The deviation was measured at presentation, under atropine cycloplegia and 3 months after full refractive correction. Of 44 children with a mean age of 5.2 ± 2.4 years, 25 were males. Eighteen (41%) had fully refractive accommodative esotropia (RAE), 10 (23%) had partial accommodative esotropia (PAE), and 5 (11%) had nonaccommodative esotropia (NAE). Eleven (25%) had convergence excess (CE). Under cycloplegia, all with RAE and RAE with CE had orthotropia. There was no significant change in the deviation in the patients with NAE. The deviation under cycloplegia and that with full refractive correction in PAE and PAE with CE (with +3.0 D addition) were not different. The intraclass correlation coefficient for deviation under cycloplegia and after full refractive correction (+3.0 D addition for CE) was 0.89. It was concluded that ocular deviation under cycloplegia can help to predict the accommodative component in esotropia with hypermetropia.