Comparative Accuracy of Cycloplegic and Non-Cycloplegic Autorefraction in Young Adults

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Background: Cycloplegic refraction is the standard for accurate measurement of refractive errors in children; however, its necessity in young adults remains debated. This study aimed to determine whether it is required in adults as well. Objectives: To compare the accuracy of cycloplegic and non-cycloplegic autorefraction in young adults and to quantify the difference in spherical equivalent (SE). Methods: A quasi-experimental study was conducted on 158 eyes of 79 subjects (aged 18–25 years) at the Ophthalmology Department, Mayo Hospital, Lahore. The average spherical equivalent (SE) was calculated before and after cycloplegia using an autorefractometer (Canon RK-5). Each eye was classified based on spherical equivalent (SE) as myopic when SE ≤ −0.50 D, emmetropic when −0.50 D < SE < +0.50 D, and hyperopic when SE ≥ +0.50 D. Cycloplegia was achieved with Cyclopentolate (1%) eye drops instilled three times, with an interval of 10 minutes to attain full cycloplegia. Data was analysed by SPSS-23. A p-value ≤ 0.05 was considered statistically significant. Results: The mean difference between non-cycloplegic and cycloplegic SE was statistically significant (P = 0.011). A strong correlation was found between pre- and post-cycloplegic sphere (r = 0.951), SE (r = 0.967), and cylindrical values (r = 0.989). The mean difference between non-cycloplegic and cycloplegic refraction was +1.26 D in hyperopic and +0.50 D in myopic eyes. Conclusion: Cycloplegic autorefraction produced a hyperopic shift of +0.16 D that was statistically significant but clinically negligible. It may not be required routinely except in cases of latent hyperopia or accommodative spasm.