Manifest, Delayed, And Cycloplegic Refractions In Hyperopia.

Background: This literature review discusses the diagnosis and treatment of latent hyperopia, and the effectiveness of delayed and cycloplegic refractive techniques. Cycloplegic refraction and delayed subjective refraction are two common techniques that optometrists use to find additional hyperopic refractive error or less myopic refractive error in a patient after a standard subjective refraction has been performed. Cycloplegic refraction is performed after the patient's accommodation has been neutralized by pharmacologically induced cycloplegia using an agent such as cyclopentolate or tropicamide. Delayed refraction is performed without the use of a
pharmacological agent. Numerous studies have shown that cycloplegic refraction typically finds a more hyperopic refractive error correction than a standard subjective refraction. Methods: A literature search was performed using the PubMed database. Results: In cases of latent hyperopia, cycloplegic refraction will find the maximum amount of hyperopia. Delayed refraction will typically show more hyperopia than a standard manifest refraction. Conclusions: Delayed refraction findings can be helpful to find the maximum amount of plus power that can be accepted by the patient. Performing a delayed refraction before cyclopleging, along with ocular posture findings and subjective symptoms will give the practitioner more information with which to make a final decision in regards to spectacle prescription.