The influence of cycloplegic in objective refraction

The purpose of this study was to compare refractions measured with an autorefractor and retinoscopy in cycloplegic and non-cycloplegic eyes. The objective refractions were performed in 199 right eyes from 199 healthy young adults with a mean age of 21.6 ±2.66 years. The measurements were performed first without cycloplegia and repeated 30 minutes later with cycloplegia. Data were analyzed using Fourier decomposition of the power profile. More negative values of component M and J0 were give by non-cycloplegic autorefraction compared to cycloplegic autorefraction (p<0.001). However more positive values were given by non-cycloplegic autorefraciton regarding to the J45 vector, althought this differences were not statistically significant (p=0.233). Regarding retinoscopy, more negative values of component M where obtained with non-cycloplegic retinoscopy (p<0.001); for the cylindrical vectors J0 and J45 the retinoscopy without cycloplegic yields more negative values (p= 0.234; p= 0.112, respectively). Accepting that differences between cycloplegic and non-cycloplegic retinoscopy are only due to accommodative response, present results confirm that when performed by an experienced clinician, retinoscopy is a more reliable method to obtain objective start point for refraction under non-cycloplegic conditions

The Pulsair 3000 tonometer - How many readings need to be taken to ensure accuracy of the average?

Manufacturers of non-contact tonometers recommend that a number of readings are taken on each eye, and an average obtained. With the Keeler Pulsair 3000 it is advised to take four readings, and average these. This report analyses readings in 100 subjects, and compares the first reading, and the averages of the first two and first three readings with the 'machine standard' of the average of four readings. It is found that, in the subject group investigated, the average of three readings is not different from the average of four in 95% of individuals, with equivalence defined as ±1.0mmHg. Copyright © 2001 The College of Optometrists