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Donny W Suh, Marjean T Kulp, Trevano W Dean, Raymond T Kraker, Sergul Ayse Erzurum, David K Wallace, Yi Pang, Caroline J Shea, John M Avallone, ; The Clinical Profile of Moderate Hyperopia in Children Three to Five Years of Age. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2207.
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© ARVO (1962-2015); The Authors (2016-present)
To describe relationships among baseline clinical findings in a cohort of children 3 to 5 years of age with moderate hyperopia participating in a 3-year randomized trial comparing glasses versus observation for development of amblyopia and strabismus.
117 children 3 to 5 years of age with hyperopia in at least one eye between +3.00D and +6.00D spherical equivalent (SE), astigmatism ≤+1.50D in both eyes, and anisometropia ≤+1.50D SE based on cycloplegic refraction were enrolled. To be eligible, children had to have no measurable heterotropia, and could not have received previous treatment for refractive error, amblyopia, or strabismus. In addition, children had to 1) demonstrate age-normal monocular visual acuity (VA) uncorrected at distance in both eyes measured without cycloplegia, using the ATS-HOTV© VA testing protocol; 2) have ≤1 line of interocular difference; and 3) demonstrate age-normal stereoacuity on the Randot Preschool Stereotest. Binocular near VA and monocular estimate method (MEM) dynamic retinoscopy were measured in a subset of subjects. Pearson correlation and partial correlation coefficients and 95% confidence intervals (CI) were calculated to evaluate relationships.
The mean age was 4.42 years, and mean SE refractive error was +3.95D in the more hyperopic eye and +3.61D in the less hyperopic eye. Greater hyperopia at baseline was associated with greater accommodative lag as measured by MEM retinoscopy (R=0.31, 95% CI= 0.05 to 0.53). Higher hyperopia at baseline was associated with worse distance VA, controlling for age (R=0.24, 95% CI= 0.06 to 0.41). Better binocular near VA was associated with better monocular distance VA controlling for age (the correlation of near VA with distance VA was 0.35 (95% CI= 0.16 to 0.51) in the better seeing eye and was 0.34 (95% CI= 0.15 to 0.51) in the worse seeing eye). Better binocular near VA was also associated with better stereoacuity (R=0.24, 95% CI = 0.04 to 0.42) controlling for age and anisometropia.
Weak to moderate associations exist among children enrolled with moderate hyperopia (+3.00D to +6.00D) and age-normal VA and stereoacuity. As expected, greater hyperopia is moderately associated with greater accommodative lag and weakly associated with worse distance VA. Better binocular near VA is moderately associated with better monocular distance VA and weakly associated with better stereoacuity.
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