Cycloplegic Use and Visual Complaints in Elementary School Students in Taiwan

Purposes: This study was to examine the frequency of atropine use as a myopia control treatment in school children in Taiwan, and to evaluate its impacts on visual functions and visual complaints. Methods: 1,067 students of ages from 7 to 12 years with no ocular or systemic diseases participated in the study. Eye examination and a questionnaire on different kinds of visual complaints were performed. Results: 36.1% of the subjects either had previously been managed with atropine (21.4%) or were treated at the time of the survey (14.7%). 33.3% of the currently treated group were also corrected with prescription spectacles, while 57.7% had no optical correction of any kind at all. The cycloplegic effect of atropine was evidenced by photophobia in conjunction with decreased BCVA, habitual near VA, and higher risks in deviating from the norm of visual functions, such as NPA, accommodation facility, binocular coordination, near phoria, AC/A ratio, NPC recovery, saccades, and stereopsis. The atropine treatment group complained of (1) blurred vision and abnormal head position when viewing distance or near, and also when using digital devices, (2) irritated eyes or ocular fatigue when viewing distance and near, and (3) seeing double images and having difficulty in the timely completion of school assignments. Conclusion: Our results show that a lack of con-current optical correction and visual function changes caused by atropine can manifest as significant visual complaints. Early detection and remedial action therefore must be instituted for students undergoing atropine myopia therapy.