Cycloplegic Refraction

An overview
A cycloplegic refraction is the procedure used to determine a patient's TRUE PRESCRIPTION (or refractive error) by temporarily paralyzing the muscles that aid in focusing using dialating drops. Dr. D primarily uses two differenct types of dialating drops, ATROPINE OR CYCLOGEL.

How are the drops used?
These drops are designed to be administered two times a day in BOTH EYES, two days prior to your Cycloplegic refraction office visit.

What are the side effects of using Atropine or Cyclogel? Blurred vision and enlarged pupil size (dilation) for up to two weeks. Patients may experience sensitivity to light and should protect their eyes in bright light during this time.

How does Atropine and Cyclogel work? Atropine and Cyclogel allow Dr. D to determine a patient's TRUE PRESCRIPTION. It does this by temporarily relaxing the muscles of the eye that aid in focusing. While taking atropine or cyclogel, it is normal to have difficulty focusing on small print.

Why do we use Atropine and Cyclogel? Atropine and cyclogel are the most effective ways to prescribe glasses for younger patients and some adults because it aids in the determinination of the patient's TRUE PRESCRIPTION.

How many total visits will this process take?
Three visits total.

1. On the first visit, we determine the need to use atropine or cyclogel drops based on the patient's age and situation. Typically younger patients benefit the most from the eye drops to find their true prescription.
2. On the second visit, we measure the eyes after they have been relaxed with the Atropine or the Cyclogel drops. This is the actual CYCLOPLEGIC REFRACTION. The drops are then discontinued after the second visit.
3. On the third visit, which is scheduled two weeks after the second visit, we determine what power the patient's glasses should be and make any necessary adjustments to the patient's best corrected vision.

Review of steps:

1. First visit: Determine the need for a cycloplegic refraction and if it is warranted either Atropine or Cyclogel is prescribed.
2. Second visit: The patient uses takes two drops of the prescribed medication in each eye two times a day for two days before the visit. On this visit the actual cycloplegic refraction is determined. The patient then STOPS THE DROPS AFTER THE SECOND VISIT.
3. Third visit: Using the previously measured cycloplegic refraction, the correct power of the patient's glasses is determined. One the third visit, the patient should also bring to the office any previous pairs of glasses they may have been given.

Warning:
Parents should be warned not to get the atropine or cyclogel in their child's mouth and to wash their hands following administration. As with all medications, please keep this drop out of the reach of young children as it can be lethal if swallowed in large quantities. Rarely this drop can cause flushing of the face and nausea.

Frequently Asked Questions:
Are all these visits REALLY necessary? According to the American Academy of Ophthalmology Manual of Pediatrics (volume 6, page 70) "One of the most important tests in the evaluation of any patient with complaints of blurred vision is refraction with a cycloplegic agent". Here at SEECA, we try to practice medicine "by the book". We are following the guidelines set forth by the Academy, and therefore feel all three visits are necessary for the most accurate refraction.

How long will the atropine or cyclogel induced blurred vision last and dilation last? In general, vision begins to clear up right after the drops are stopped but occasionally residual blurring and iris dilation may last up to 10 days.

Will this procedure need to be performed every year? No. In most cases, once we find the patient's true refraction, it is not necessary to repeat the cycloplegic refraction. That this means is that, in general, once is enough.