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Child Diagnosed Myopic With Astigmatism. Will Cycloplegic Refraction Be Helpful In Getting A More Acute Prescription?

Posted on Wed, 4 Sep 2013

Question: Dear doctor, i recently got my 4 yrs old daughter's refraction done since she used to go too near to the TV at times. She has been detected to be myopic (-1.75), with astigmatism (180 degrees) both eyes. I had heard children need cycloplegic refraction before prescription, but the ophthalmologist says she does not need that, since she has myopia and astigmatism. He also said that it cycloplegic refraction needs to be done in high hypermetropes and in strabismus. Although i am more inclined to trust his advice, i still want to make sure if doing a cycloplegic refraction would be helpful in getting her a more accurate prescription. I am confused about it. Kindly opine and let me know if i should get the cycloplegic refraction or get her the specs right away? I want to do whatever is in her best interest.
Thanks and regards, XXXXXXX

Answered by Dr. N K Mishra (36 minutes later)

Dear XXXXXXX
thanks for sending your query to us.
I am happy to note your concern,your daughter has myopia.This needs correction and we usually do not do cycloplegic refraction in myopes.
More importently there are few things which are to be kept in mind,
take care of her diet
after a inetial week she will be fully adjusted with glasses and will wear them most of the time.
you have to have almost yearly checkups to monitor the progress of power.
class 12 onwords she can wear contact lenses
she can have surgery to remove glasses after she is 22
you can start with these glasses immediately.
Please do get back to me in case of any further query in this regard.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. N K Mishra (8 minutes later)

Dear Dr. Misra,
Thanks for replying promptly. You have addressed all my concerns, there are 2 more things I want to know,
1. Would cycloplegic refraction give a better and more accurate prescription to her? Or it wont make much of difference? My concern is that if her cylindrical axis is not accurate, she may not accept the glasses.
2. Do i need to show her to a cornea specialist to rule out keratoconus? Or i am googling too much?
Thanks for your time and patience.

Answered by Dr. N K Mishra (7 minutes later)

Dear XXXXXXX
get her glasses.At this age we have to follow our own instincts rather than being too accurate as most of such young children do not co operate too much and please do not think about keratoconus
Still any further query ,do get back to me.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. N K Mishra (30 minutes later)

Thanks Sir, that has really brought peace to my mind. My last query, would LASIK be effective for astigmatism?
Thanks.

Answered by Dr. N K Mishra (6 minutes later)

Dear XXXXXXX
LASIL is what i meant by surgery ,to be taken up after the power is settled for at least 2years.18 years is too long a time in medicine and the way things are progressing we definetly will be having something better to offer then.
do not worry too much,she will be fine.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. N K Mishra (1 minute later)

Thanks Sir, for being so patient with even my over-the-board queries. Thanks for pacifying my concerns, I can now get her the glasses right away.
Wish you all the best.
Warm regards.

Answered by Dr. N K Mishra (5 minutes later)

you are always welcome XXXXXXX !

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar