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Elise Ciner, Vision in Preschoolers - Hyperopia in Preschoolers Study Group; Vision In Preschoolers - Hyperopia In Preschoolers (VIP - HIP) Study: Visual function differences between Hyperopes and Emmetropes.. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2206.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the visual function of uncorrected hyperopic(≥3 to ≤6 diopters [D]) and emmetropic children without strabismus or amblyopia who were enrolled in the Vision in Preschoolers - Hyperopia in Preschoolers study.
Participants were children 4 to 5 years old attending preschool or kindergarten, who had never received refractive correction. Data collection included threshold monocular visual acuity (VA) at distance and binocular VA at near with crowded HOTV, accommodative response by Monocular Estimation Method (MEM) and Grand Seiko autorefraction at 33cm, and stereoacuity (up to 30 sec arc) by Preschool Assessment of Stereopsis with a Smile (PASS). Cycloplegic autorefraction was performed using Retinomax to confirm the presence of either hyperopia (≥3.0D to ≤6.0D in the most hyperopic meridian of at least one eye; astigmatism ≤1.5D and anisometropia ≤1.0D) or emmetropia (hyperopia <1.0D; myopia, astigmatism and anisometropia <1.0D). Cover test at distance and near and VA were used to rule out strabismus or amblyopia.
492 children (244 hyperopes and 248 emmetropes) participated (mean age 58 months; mean [+SD] spherical equivalent refractive error +3.47D+0.81 in hyperopes and +0.37D+0.50 in emmetropes). Mean logMAR distance VA was better for emmetropes than hyperopes (0.10±0.11 vs. 0.19±0.10, p<.001) and more emmetropes than hyperopes were able to achieve VA of at least 20/20 in the better seeing eye (53.6% vs. 21.4%, p<0.001). The mean logMAR VA at near in emmetropes was better than hyperopes (0.13±0.11 vs. 0.21±0.11, p<.001), with 20/20 VA attained by 23.8% of emmetropes vs. 5.3% of hyperopes (p<0.001). Mean accommodative lag in emmetropes was smaller than in hyperopes for both MEM (1.0±0.5 vs. 2.0±1.0, p<0.001) and Grand Seiko (0.9±0.6 vs. 1.8±1.1, p<0.001). More emmetropes (59.3%) than hyperopes (16.4%) were able to achieve one of the two best tested stereoacuity levels (30 or 40 sec arc, p<0.001). Mean stereoacuity was better in emmetropes than hyperopes (67±60 sec arc vs.166±137 sec arc, p<.001).
Visual function as measured with VA, accommodative response and stereoacuity was significantly better in emmetropes compared to uncorrected hyperopes in this group of 4 to 5 year old children without strabismus or amblyopia. It is not known if correction of the hyperopia at this age improves these visual skills.
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