Prescribing Patterns for Hyperopia

Abstract

Purpose : Hyperopia is the most common vision diagnosis in children. However, there are no evidence-based prescribing guidelines for managing hyperopia. The purpose of this study was to survey pediatric eye care providers to identify current patterns of prescribing for bilateral hyperopia when considering magnitude of hyperopia as well as other factors.

Methods : Pediatric eye care providers who were members of professional organizations or listservs were invited via email to participate in a Qualtrics survey study of current pediatric spectacle prescribing practices. Participants answered questions on “What factors influence whether or not you prescribe for bilateral hyperopia” and “At what level of bilateral hyperopia would you typically prescribe correction for a child with age-normal distance visual acuity (VA) and near visual function, and no strabismus (manifest deviation) or symptoms (select the lowest level in spherical equivalent [SE])”. The distribution of responses given by ophthalmologists and optometrists was compared using Kolmogorov-Smirnov CDF test (after excluding “would not prescribe” responses).

Results : As shown in Table 1, eye care providers reported that symptoms, presence of astigmatism and/or anisometropia, reading problems, and accommodative function were most commonly considered when prescribing for hyperopia; cost and possibility of teasing by peers were least commonly considered. When considering factors for prescribing glasses for hyperopia, ophthalmologists and optometrists differed significantly for every factor except symptoms and possibility of teasing. Among factors showing the greatest differences were stereoacuity, emmetropization, and near visual acuity, where optometrists were more likely to consider these factors than ophthalmologists (Table 1). The level of hyperopia at which more than 50% of all eye care providers reported prescribing decreased with patient age from +5D at age 6 to <11 months (54.9%) to +4.5D for 1 to <2 years (53.9%) to +4D for 2 to <4 years (65.5%) to +3D for 4 to <7 years (51.1%) and for ≥7 years (59.2%). The distribution between ophthalmologists’ and optometrists’ responses was significantly different (p < 0.0001).

Conclusions : Disagreement remains among eye care providers in prescribing for children with low and moderate hyperopia.

This is a 2021 ARVO Annual Meeting abstract.