Why do children need to undergo “mydriasis” eye examination? Will it have any effect on children’s eyes?

#千万IP创科普# When hospitals check children’s eyesight, they usually mention a word: mydriasis.

Many parents do not know why children need to have their pupils dilated when they are fitted with glasses, and they are especially worried about whether dilation will have an impact on their children's eyes. Today, Dr. Wei Zhihuan from the Ophthalmology Center of the Children's Hospital of Quanzhou Maternal and Child Health Hospital will talk to you in detail.

What is mydriatic optometry?
Optometry: It is to check the focusing of light after it enters the eyeball. The purpose is to accurately measure the patient's refractive power through precise and detailed refractive examinations such as retinoscopy, so as to enable the patient to achieve clear vision, use the eyes comfortably, and read for a long time.

Cycloplegic optometry : also known as ciliary muscle paralysis optometry , is an optometry process in which ciliary muscle paralyzing eye drops are instilled before optometry to relax eye accommodation and obtain the most realistic refractive state of the eye.
Since all current ciliary muscle paralysis drugs will cause pupil dilation, it is commonly known as "mydriasis optometry"

Why do we need mydriasis refraction?

The purpose of mydriasis refraction is to eliminate the influence of the adjustment ability of the eyes and obtain a more realistic refractive state. In short, it is to accurately measure the refraction of the eyes. Especially for children and adolescents, the ciliary muscles of the eyes have strong adjustment ability. If the "mydriasis" is not performed during the first eye examination, the refractive degree obtained by the eye examination may be inaccurate.

Under what circumstances is mydriasis refraction necessary?

1. Most children and adolescents need mydriasis for their first eye examination

2. Children are considered to have strong accommodation tension interference (such as moderate to high hyperopia, with or without amblyopia, strabismus, or moderate to high astigmatism), and need mydriasis refraction

3. For adolescents and even adults who have been working at close range for a long time, reading intensively, and using their eyes, it is considered that there may be accommodation interference, and the pupil can be dilated for refraction.

4. Before refractive surgery (laser correction of myopia, intraocular contact lens implantation), the optometry needs basic data of mydriasis optometry and subjective optometry to ensure the accuracy of the examination results.

5. Children under 16 years old with hyperopic refractive error, especially those with esotropia

6. Children with impaired vision

7. Those with abnormal corrected vision that cannot be explained by other eye diseases

Under what circumstances can mydriasis refraction not be performed?

In the following situations, mydriasis refraction cannot be performed?

1. Patients with angle-closure glaucoma or shallow anterior chamber

2. People who are allergic to cholinesterase inhibitors

3. Mydriasis is generally not recommended for patients with epilepsy, or medication must be taken under the supervision of a doctor

4. People who need to work in close proximity in the near future

Are mydriatic drugs harmful to the eyes?

There are generally no complications in mydriasis refraction, but patients may experience photophobia, difficulty in near vision, or adverse reactions to atropine within a short period of time after mydriasis. These are normal phenomena of medication and will recover on their own.

How long does mydriasis refraction usually take?

Short-acting mydriatic drugs generally take about an hour to work. If long-acting mydriatic drugs (atropine) are used to dilate the pupil, the mydriasis process will take about three to five days.

How long does it take for the pupil to return to normal after dilation?

Short-acting mydriatic drugs generally take 6-8 hours to recover, medium-acting mydriatic drugs take 3-5 days to recover, and if atropine is used to dilate the pupil, it will take about 3 weeks to recover.

Will mydriasis harm children's eyes?

Mydriasis itself will not cause harm to the eyes. The side effects of using mydriasis eye drops (enlarged pupils, photophobia, difficulty seeing near objects, etc.) are temporary and can recover on their own. It's just that the recovery time varies for different drugs and different physical conditions, so there is no need to worry too much.

But please note that mydriasis is a medical procedure and must be performed under the strict guidance of a doctor. Mydriasis can only be performed safely after excluding some contraindications (such as angle-closure glaucoma, shallow anterior chamber, narrow chamber angle, etc., which may induce increased intraocular pressure).