Accurate paediatric refraction is essential for detecting and managing vision issues, including latent hyperopia, amblyopia, accommodative esotropia, and progressive myopia. Cycloplegic agents are critical for obtaining precise measurements in children, yet their use varies due to professional, regulatory, and systemic barriers. In Malaysia, where refractive services are divided between the public and private sectors, limited data exist on how eye care professionals implement cycloplegic refraction in paediatric practice.