{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:21:56Z","timestamp":1789114916706,"version":"build-2803163510"},"reference-count":0,"publisher":"Press of International Journal of Ophthalmology (IJO Press)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Ophthalmol"],"published-print":{"date-parts":[[2026,10,18]]},"abstract":"<jats:p>AIM: To quantify the impact of the measurement of non-cycloplegic refraction on estimates of refraction and classification of refractive status in young adults.\nMETHODS: This cross-sectional analysis included 825 young adults (mean age 26.6\u00b13.3y; 56.7% female) from the Guangzhou Twin Eye Study. All participants underwent both non-cycloplegic and cycloplegic autorefraction. Error in refraction was defined as the difference between cycloplegic and non-cycloplegic spherical equivalent refraction (SER).\nRESULTS: Using a cut-off of -0.50 D for non-cycloplegic refraction to diagnose myopia, the prevalence of myopia was overestimated (90.2% vs 87.0%), resulting in the identification of 3.2% (26\/825) pseudo-myopes. After increasing the threshold to -0.75 D, the overall prevalence (87.5%) was approximately equivalent to that with cycloplegic refraction, 9 of the 26 pseudo-myopes would have been re-classified correctly as emmetropes, but 13 genuine myopes would have been re-classified incorrectly as emmetropes. Lack of cycloplegia resulted in a significant myopic shift compared to cycloplegic refraction. Notably, 25.6% of participants exhibited a clinically significant myopia refractive shift of \u22650.50 D, and 5.7% demonstrated a large shift of \u22651.00 D.\nCONCLUSION: At a threshold of -0.75 D, the calculated prevalence of myopia is close to that obtained with cycloplegic refraction. However, threshold adjustment does not solve the mis-classification problem, because while it will eliminate some pseudo-myopes, it will also eliminate some genuine myopes. Our study confirms that non-cycloplegic refraction leads to significant measurement errors in young adults, highlighting the necessity of cycloplegia for accurate epidemiologic assessment of myopia prevalence.<\/jats:p>","DOI":"10.18240\/ijo.2026.10.18","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:25:34Z","timestamp":1789111534000},"page":"2026-2030","source":"Crossref","is-referenced-by-count":0,"title":["Cycloplegia is required for accurate refraction of young adults in epidemiologic studies"],"prefix":"10.18240","volume":"19","author":[{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Jie","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan-Zhen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen-Jia","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Qian","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian G","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China; Research School of Biology, College of Medicine, Biology and Environment, Australia National University, Canberra 2601, Australia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-Guang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China;","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Hu","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, Guangdong Province, China","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"7543","container-title":["International Journal of Ophthalmology"],"original-title":[],"link":[{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/pdf\/20261018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:25:39Z","timestamp":1789111539000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ijo.cn\/gjyken\/article\/abstract\/20261018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,18]]},"references-count":0,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10,18]]}},"URL":"https:\/\/doi.org\/10.18240\/ijo.2026.10.18","relation":{},"ISSN":["2222-3959","2227-4898"],"issn-type":[{"value":"2222-3959","type":"print"},{"value":"2227-4898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,18]]}}}