September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Vision In Preschoolers-Hyperopia In Preschoolers (VIP-HIP) Study: Associations between visual function and magnitude of refractive error for emmetropic to moderately hyperopic children
Author Affiliations & Notes
  • Elise B Ciner
    Salus University, Elkins Park, Pennsylvania, United States
  • Marjean T Kulp
    College of Optometry, Ohio State University, Columbus, Ohio, United States
  • Maureen G Maguire
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Maxwell Pistilli
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • T. Rowan Candy
    College of Optometry, Indiana University, Bloomington, Indiana, United States
  • Gui-Shuang Ying
    Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Graham E Quinn
    Ophthalmology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
  • Bruce D Moore
    New England College of Optometry, Boston, Massachusetts, United States
  • Lynn Cyert
    College of Optometry, Northeastern State University, Tahlequah, Oklahoma, United States
  • Footnotes
    Commercial Relationships   Elise Ciner, None; Marjean Kulp, None; Maureen Maguire, None; Maxwell Pistilli, None; T. Rowan Candy, None; Gui-Shuang Ying, None; Graham Quinn, None; Bruce Moore, None; Lynn Cyert, None
  • Footnotes
    Support  NIH/NEI Grant R01EY021141
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1535. doi:
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      Elise B Ciner, Marjean T Kulp, Maureen G Maguire, Maxwell Pistilli, T. Rowan Candy, Gui-Shuang Ying, Graham E Quinn, Bruce D Moore, Lynn Cyert; Vision In Preschoolers-Hyperopia In Preschoolers (VIP-HIP) Study: Associations between visual function and magnitude of refractive error for emmetropic to moderately hyperopic children. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1535.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : To evaluate previously unknown associations between visual function and uncorrected spherical equivalent (SE) refractive error in emmetropic and hyperopic children without strabismus or amblyopia and <1D of anisometropia or astigmatism.

Methods : Children aged 4 or 5 years in preschool were enrolled. Visual functions assessed included monocular distance visual acuity (VA), binocular near VA (crowded HOTV), accommodative lag (Monocular Estimation Method [MEM] and Grand Seiko [GS]), and near stereoacuity by Preschool Assessment of Stereopsis with a Smile (PASS). Cycloplegic autorefraction with Retinomax confirmed eligibility (<1.0D in the most myopic meridian to ≤6.0D in the most hyperopic meridian with anisometropia and astigmatism <1D). Distance and near cover test and distance VA ruled out strabismus or amblyopia. Children were classified as Group 1 (<+1D); Group 2 (>+1 to <+3D); or Group 3 (+3 to +6D) SE refraction. Visual functions were analyzed by group and as continuous variables as a function of SE.

Results : 554 children were included in the analysis (mean age 58 months). Mean SE(±SD)(N) for the groups were +.52D(±.49)(270); +2.18D(±.57)(113) and +3.95D(±.78)(113). For each visual function analyzed either as groups or as continuous variables, there was a consistent trend of poorer performance with increasing SE (p<0.001). More children in Groups 1 (52%,26%) and 2 (47%,15%) compared to Group 3(25%,9%) were able to achieve (distance, near) VA of 20/20 or better. While mean (±SD) logMAR VA was different for Groups 1-3 for distance (.05(±.10); .06(±.10);.12(±.11)) and near (.13(±.11); .15(±.10); .19(±.11)) (p<.001), all were within normal age ranges. Accommodative responses were less accurate with increasing hyperopia (ρ=0.33 GS, 0.50 MEM [p<0.001 for both]). Lags were greater with MEM than GS (p<0.001). Median near stereoacuities were 40, 60 and 120 sec arc for Groups 1 to 3 with more children in Group 1(23%) than 2(13%) or 3(7%) achieving 30 sec arc. The percentage of children with no reduced near visual functions for VA, PASS or GS for Groups 1 to 3 was 81%; 64%; and 39%. (Table)

Conclusions : Decreased function (VA, accommodative lag and stereoacuity) was associated with increasing hyperopia in these children. It is not known how these visual functions change with time or optical correction.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

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