ABSTRACT Purpose The purpose of this pilot study was to assess the effect of 0.05% low‐dose atropine on ocular accommodation (amplitude and accuracy) and how its effect changed throughout the day. Methods Sixteen children aged 6–16 years using 0.05% atropine and 16 controls not using atropine were enrolled. Monocular accommodative amplitude was measured objectively using a Grand Seiko WAM‐5500 open field autorefractor (formerly manufactured by RyuSyo Industrial Co.) and subjectively using the push‐up method. Accuracy of accommodation was measured using monocular estimation (MEM) retinoscopy. All measures were taken at three study visits over a single day to assess change over time. Measures of accommodative amplitude and accuracy were compared using a 2‐way analysis of variance (ANOVA). Nonparametric analyses were performed to compare MEM retinoscopy using the Mann–Whitney U ‐test and Friedman's test. Results Objectively measured accommodative amplitude was significantly lower in the 0.05% atropine group (morning: 5.99 ± 2.28D, midday: 6.17 ± 2.06D, afternoon: 7.08 ± 1.82D) compared to the control group (morning: 7.68 ± 1.59D, midday: 7.62 ± 1.93D, afternoon: 7.63 ± 1.48D) at the morning and midday visits ( p = 0.01, 0.03). There was no difference between groups at the afternoon visit ( p = 0.40). In the 0.05% atropine group, objectively measured amplitudes were greater at the afternoon visit compared to those of the morning and midday visits ( p < 0.01). There were no significant differences throughout the day in the push‐up amplitude of accommodation or MEM retinoscopy. Conclusions When measured objectively, accommodative amplitude in children using 0.05% low‐dose atropine was reduced compared to controls during the morning and midday visits and increased over the day reaching a level comparable to that of the control group by the afternoon visit. Common clinical measures of accommodative ability, including subjective amplitude of accommodation using the push‐up test and accommodative accuracy using MEM retinoscopy, did not demonstrate these same differences.
Maxwell et al. (Sun,) studied this question.