a. 
A 6 year-old boy with accommodative esotropia has an objective refraction of +5.00DS in each eye without cycloplegia. If atropine were instilled before the refraction, what would happen to the objective refraction?

b. 
An eye has a visual acuity of 6/9 uncorrected. A +1.25D lens improves the vision to 6/6 and it remains 6/6 with +1.75D. A +2.00D reduces the vision to 6/9. What is the:

i. value of the manifest hypermetropia?
ii. value of the facultative hypermetropia?
iii. value of the absolute hypermetropia?

 
Answer a
Cycloplegia abolishes accommodation. With cycloplegic refraction, the resulting objective refraction will have more plus (or less minus) than without cycloplegia.
 

Answer b 
For gazing at distance without cycloplegia, the least plus correction 
required for clear distance vision is termed absolute hypermetropia. The most plus correction the eye can accept without blurring of the image is the manifest hypermetropia. The diopters between the least and most accepted plus correction constitute the amount of hypermetropia that is facultative. 
i. +1.75D
ii. +0.50D
iii. +1.25D