Effect of Near Work on Comparison of Cycloplegic and Non-Cycloplegic Refraction in Young Myopes
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Abstract
Background: Near work may increase accommodative demand and influence non-cycloplegic refractive measurements in young myopic individuals, potentially leading to overestimation of myopia. Cycloplegic refraction minimizes accommodative activity and may provide a more accurate estimate of refractive status when residual accommodation is suspected. Objective: To compare post-near-work non-cycloplegic and cycloplegic mean spherical equivalent refraction in young myopes and to assess whether refractive variability is associated with daily near-work duration or duration of myopia. Methods: This cross-sectional analytical study included 80 myopic participants aged 16–25 years recruited from two tertiary hospitals in Pakistan between January and April 2026. Participants completed a standardized 10-minute digital near-work task at 25–30 cm. Non-cycloplegic refraction was performed immediately afterward using autorefractometry followed by subjective refraction. Cycloplegia was induced with cyclopentolate 1%, and cycloplegic refraction was performed 40 minutes after the final drop using retinoscopy. Paired t-tests and correlation analyses were performed. Results: Non-cycloplegic refraction was more myopic than cycloplegic refraction in both eyes. Mean refractive differences were 0.68 ± 0.42 D in the right eye and 0.63 ± 0.44 D in the left eye, both statistically significant (p < 0.001). Refractive variability was not significantly associated with daily near-work duration or duration of myopia. Conclusion: Young myopes showed clinically meaningful accommodative influence on post-near-work non-cycloplegic refraction. Cycloplegic refraction may be considered when accurate refractive evaluation is required
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