2,7) In particular, this is important as a further indication for treatment with exercises, since some cases of accommodative anomalies will be as a result of significant latent hyperopia; if a low refractive error is found, it would be appropriate to carry out a cycloplegic
assessment before prescribing the low refractive error.
Control of accommodation in children of pre-school age is more commonly achieved by pharmacological means, using cycloplegic agents such as cyclopentolate and tropicamide; atropine can only be used by therapeutically qualified practitioners.
This is notably so because the acidic pH of the cycloplegic agent leads to stinging on instillation.
It was also claimed that the optometrist did not undertake retinoscopy with a cycloplegic
agent in circumstances where the examination indicated a visual acuity of 3/9, stereo acuity was 200 seconds of arc, there was limited cooperation from the child patient, and the reason for the examination was she had been squinting and closing her eyes when watching television.
refraction at a six-year-old child's first eye examination yielded the clinical information shown in Image B.
Any uncorrected refractive error should be accounted for with a cycloplegic
Key advice was offered on the risk factors to consider for heterotropia and amblyopia (eg, maternal drug use, genetics/family history, forceps injury and prematurity), the importance of crowding effects on VA measurements, the usefulness of the 20 Base Out prism test for detecting amblyopia, indications for cycloplegic
refraction, and indications for occlusion therapy.
10) In the case of significant latent hyperopia, it is important to consider that the cycloplegic
result is a clue to the manifest situation when the patient is over 50 years of age.
As with VKC, bandage contact lenses, ocular lubricants and prophylactic antibiotics and sometimes cycloplegics
are required for corneal ulcers or persistent epithelial defects.