March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Relationship of Hyperopia with Amblyopia, Strabismus, and Stereoacuity in Preschool Children
Author Affiliations & Notes
  • Marjean T. Kulp
    College of Optometry, Ohio State University, Columbus, Ohio
  • Gui-Shuang Ying
    Ophthalmology, Scheie Eye Institute, Philadelphia, Pennsylvania
  • Jiayan Huang
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
  • Maureen G. Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
  • Elise Ciner
    Pennsylvania College of Optometry, Salus University, Philadelphia, Pennsylvania
  • Lynn A. Cyert
    Oklahoma College of Optometry, Northeastern State Univ, Tahlequah, Oklahoma
  • Graham E. Quinn
    Pediatric Ophthalmology, Childrens Hospital of Philadelphia, Philadelphia, Pennsylvania
  • Bruce Moore
    New England College of Optometry, Boston, Massachusetts
  • Deborah A. Orel-Bixler
    School of Optometry, University of California, Berkeley, Berkeley, California
  • Vision In Preschoolers (VIP) Study Group
    College of Optometry, Ohio State University, Columbus, Ohio
  • Footnotes
    Commercial Relationships  Marjean T. Kulp, None; Gui-Shuang Ying, None; Jiayan Huang, None; Maureen G. Maguire, None; Elise Ciner, Vision Associates (F); Lynn A. Cyert, None; Graham E. Quinn, None; Bruce Moore, None; Deborah A. Orel-Bixler, None
  • Footnotes
    Support  NEI/NIH, DHHS grants: U10EY12644; U10EY12547; U10EY12545; U10EY12550; U10EY12534; U10EY12647; U10EY12648 and R21EY018908
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 153. doi:
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      Marjean T. Kulp, Gui-Shuang Ying, Jiayan Huang, Maureen G. Maguire, Elise Ciner, Lynn A. Cyert, Graham E. Quinn, Bruce Moore, Deborah A. Orel-Bixler, Vision In Preschoolers (VIP) Study Group; Relationship of Hyperopia with Amblyopia, Strabismus, and Stereoacuity in Preschool Children. Invest. Ophthalmol. Vis. Sci. 2012;53(14):153.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To investigate the relationship between hyperopia >3.25D and amblyopia, strabismus, and stereoacuity among Head Start Preschoolers.

Methods: : 3- to 5-year old children (n=4040) underwent a comprehensive vision examination including monocular visual acuity (VA) testing, cover testing, and cycloplegic refraction during Phases I (A&B) and II of the Vision In Preschoolers (VIP) study. VA was tested with habitual correction, if any, and was retested with full cycloplegic correction when (1) VA was worse than 20/50 for 3-year-olds or 20/40 for 4- to 5-year-olds or a child showed an interocular acuity difference (IOD) ≥ 2 lines; AND (2) cycloplegic refraction showed hyperopia ≥ 2.0 D, myopia ≥ -0.5 D, or astigmatism ≥ 1.0 D in either eye. Stereoacuity testing (Stereo Smile) also was performed on 2898 children during Phases IB and II. Hyperopia was classified into 3 levels of severity: group 1= ≥+5.00D, group 2= >+3.25D to <+5D with spherical equivalent (SE) >0.5D, and group 3 = >+3.25D to <+5D with SE<0.5D.

Results: : Children with hyperopia >3.25D (N=466) had a significantly higher proportion of amblyopia (35% vs. 2.8%, p < 0.001) and strabismus (17% vs. 2.2%, p < 0.001) with a higher proportion of each associated with more severe levels of hyperopia (amblyopia: 13.3% (group 3) to 52.8% (group 1), strabismus: 8.4% (group 3) to 32.9% (group 1), p < 0.001 for both). Odds of amblyopia increased by 18.1 and odds of strabismus increased by 9.13 times with the presence of hyperopia. The median stereoacuity of nonstrabismic children with hyperopia (N=290) (240") was significantly worse than that of children without hyperopia (60") (p<0.001) and more severe levels of hyperopia were associated with worse stereoacuity (120" for groups 2 and 3, 480" for group 1, p<0.001).

Conclusions: : The presence and magnitude of hyperopia among preschoolers was associated with an increased proportion of amblyopia and strabismus and with worse stereoacuity even among non-strabismic children.

Keywords: hyperopia • amblyopia • strabismus 

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