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The long-term outcome of the refractive error in children with hypermetropia

  • Pediatrics
  • Published:
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Abstract

Purpose

The purpose of this study was to investigate the long-term outcome of high hypermetropic refractive errors in childhood.

Methods

We retrospectively reviewed data from the clinical records of 164 children with spherical equivalent (SE) hypermetropic refractive errors in three medical centers collected over 29 years. Refractive errors between +1.00 and +3.00 diopter (D) on initial examination were classified as mild hypermetropia and those +5.00D or greater were classified as high hypermetropia. The four variables studied were, age, refractive error, strabismus, and gender. The rate of reduction in hypermetropic refractive error was calculated over time in years. We identified subgroups according to age, gender, and initial refractive error.

Results

Seventy-eight children with high hypermetropia and 86 children with mild hypermetropia were studied. High hypermetropia was detected at a mean age of 3.3 years, while mild hypermetropia was detected at a mean 4 years of age. The mean follow-up was 6.6 years for high hypermetropia and 6.4 years for mild hypermetropia. Over the follow-up period, children in all subgroups tended to reduce their refractive errors. The reduction in refraction power was small for both mild and high hypermetropic refractive errors. Amblyopia in the high hypermetropia group was more common and more refractory to treatment.

Conclusions

Most children with hypermetropia of less than +3.00D experience a reduction in hyperopic refractive error over time and will outgrow any need for corrective lenses. Children with hyperopia greater than +5.00D will not experience a significant reduction in the power of the refractive error.

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References

  1. Cook RC, Glasscock RE (1951) Refractive and ocular findings in the newborn. Am J Ophthalmol 34(10):1407–1413

    Article  CAS  PubMed  Google Scholar 

  2. Atkinson J, Braddick O, Nardini M, Anker S (2007) Infant hyperopia: detection, distribution, changes and correlates-outcomes from the Cambridge infant screening programs. Optom Vis Sci 84(2):84–96

    Article  PubMed  Google Scholar 

  3. Robaei D, Rose K, Ojaimi E et al (2005) Visual acuity and the causes of visual loss in a population-based sample of 6-year-old Australian children. Ophthalmology 112(7):1275–1282

    Article  PubMed  Google Scholar 

  4. Ip JM, Huynh SC, Robaei D et al (2008) Ethnic differences in refraction and ocular biometry in a population-based sample of 11–15-year-old Australian children. Eye (London) 22(5):649–656

    Article  CAS  Google Scholar 

  5. Ojaimi E, Rose KA, Morgan IG et al (2005) Distribution of ocular biometric parameters and refraction in a population-based study of Australian children. Invest Ophthalmol Vis Sci 46(8):2748–2754

    Article  PubMed  Google Scholar 

  6. Hirsch M, Weymouth F (1991) Prevalence of refractive anomalies. In: Grovenor T, Flom M (eds) Refractive abnormalities research and clinical applications. Butterworth-Heinemann, Boston

    Google Scholar 

  7. Colburn JD, Morrison DG, Estes RL et al (2010) Longitudinal follow-up of hypermetropic children identified during preschool vision screening. J AAPOS 14(3):211–215

    Article  PubMed  Google Scholar 

  8. Ingram RM, Gill LE, Lambert TW (2008) Effect of spectacles on changes of spherical hypermetropia in infants who did, and did not, have strabismus. Br J Ophthalmol 84(3):324–326

    Article  Google Scholar 

  9. Blouza JA, Loukil I, Mhenni A et al (2007) Management of hyperopia in children. J Fr Ophtalmol 30(3):255–259

    Article  Google Scholar 

  10. Li CH, Chen PL, Chen JT, Fu JJ (2009) Different corrections of hypermetropic errors in the successful treatment of hypermetropic amblyopia in children 3 to 7 years of age. Am J Ophthalmol 147(2):357–363

    Article  PubMed  Google Scholar 

  11. Walline JJ, Sinnott L, Johnson ED et al (2008) What do kids think about kids in eyeglasses? Ophthalmic Physiol Opt 28(3):218–224

    Article  PubMed  Google Scholar 

  12. Edwards M (1991) The refractive status of Hong Kong Chinese infants. Ophthalmic Physiol Opt 11(4):297–303

    Article  CAS  PubMed  Google Scholar 

  13. Saunders KJ, Woodhouse JM, Westall CA (1995) Emmetropisation in human infancy: rate of change is related to initial refractive error. Vis Res 35(9):1325–1328

    Article  CAS  PubMed  Google Scholar 

  14. Breslin KM, O’Donoghue L, Saunders KJ (2013) A prospective study of spherical refractive error and ocular components among Northern Irish schoolchildren (the NICER study). Invest Ophthalmol Vis Sci 54(7):4843–4850

    Article  PubMed  Google Scholar 

  15. Littell R, Milliken G, Stroup W et al (2006) SAS for mixed models, 2nd edn. SAS Institute, Inc., Cary

    Google Scholar 

  16. Mayer DL, Hansen RM, Moore BD et al (2001) Cycloplegic refractions in healthy children aged 1 through 48 months. Arch Ophthalmol 119(11):1625–1628

    Article  CAS  PubMed  Google Scholar 

  17. Mutti DO, Mitchell GL, Jones LA et al (2005) Axial growth and changes in lenticular and corneal power during emmetropization in infants. Invest Ophthalmol Vis Sci 46(9):3074–3080

    Article  PubMed  Google Scholar 

  18. Mutti DO, Mitchell GL, Jones LA et al (2009) Accommodation, acuity, and their relationship to emmetropization in infants. Optom Vis Sci 86(6):666–676

    Article  PubMed Central  PubMed  Google Scholar 

  19. Kuo A, Sinatra RB, Donahue SP (2003) Distribution of refractive error in healthy infants. J AAPOS 7(3):174–177

    Article  PubMed  Google Scholar 

  20. French AN, Morgan IG, Mitchell P, Rose KA (2013) Risk factors for incident myopia in Australian schoolchildren: the Sydney adolescent vascular and eye study. Ophthalmology 120(10):2100–2108

    Article  PubMed  Google Scholar 

  21. Saunders KJ (1995) Early refractive development in humans. Surv Ophthalmol 40(3):207–216

    Article  CAS  PubMed  Google Scholar 

  22. Tarczy-Hornoch K (2007) The epidemiology of early childhood hyperopia. Optom Vis Sci 84(2):115–123

    Article  PubMed  Google Scholar 

  23. Gwiazda J, Thorn F, Bauer J, Held R (1993) Myopic children show insufficient accommodative response to blur. Invest Ophthalmol Vis Sci 34(3):690–694

    CAS  PubMed  Google Scholar 

  24. Ohlsson J, Baumann M, Sjostrand J (2004) Longterm refractive and visual outcomes in subjects with high hyperopia. Acta Ophthalmol Scand 82(4):486–487

    Article  PubMed  Google Scholar 

  25. Kulp MT, Foster NC, Holmes JM et al (2012) Effect of ocular alignment on emmetropization in children <10 years with amblyopia. Am J Ophthalmol 154(2):297–302, e1

    Article  PubMed Central  PubMed  Google Scholar 

  26. Bankes JL (1983) Do unnecessary spectacles make the eyes worse. Arch Dis Child 58(10):766

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  27. Teikari J, Koskenvuo M, Kaprio J, O’Donnell J (1990) Study of gene-environment effects on development of hyperopia: a study of 191 adult twin pairs from the Finnish Twin cohort study. Acta Genet Med Gemellol (Roma) 39(1):133–136

    CAS  Google Scholar 

  28. Medina A (1987) A model for emmetropization: predicting the progression of ametropia. Ophthalmologica 194(2–3):133–139

    Article  CAS  PubMed  Google Scholar 

  29. Atkinson J, Braddick O, Robier B et al (1996) Two infant vision screening programmes: prediction and prevention of strabismus and amblyopia from photo- and videorefractive screening. Eye (London) 10(Pt 2):189–198

    Article  Google Scholar 

  30. Simons K (2005) Amblyopia characterization, treatment, and prophylaxis. Surv Ophthalmol 50(2):123–166

    Article  PubMed  Google Scholar 

  31. Edelman PM, Borchert MS (1997) Visual outcome in high hypermetropia. J AAPOS 1(3):147–150

    Article  CAS  PubMed  Google Scholar 

  32. Fern KD (1989) Visual acuity outcome in isometropic hyperopia. Optom Vis Sci 66(10):649–658

    Article  CAS  PubMed  Google Scholar 

  33. Schoenleber DB, Crouch ER Jr (1987) Bilateral hypermetropic amblyopia. J Pediatr Ophthalmol Strabismus 24(2):75–77

    CAS  PubMed  Google Scholar 

  34. Chen W, Chen J, Zhang F et al (2013) Visual outcome in isoametropic amblyopic children with high hyperopia and the effect of therapy on retinal thickness. Am J Ophthalmol 155(3):536–543, e1

    Article  PubMed  Google Scholar 

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Acknowledgments

We would like to thank Prof. Ayala Cohen and Dr. Tatiana Umansky, Statistics Laboratory, Faculty of Industrial Engineering and Management, Technion – Israel Institute of Technology, Haifa, Israel, and Boris Futerman, MSc, Clinical Epidemiology Unit, Rambam Healthcare Campus, Haifa, Israel, for performing the statistical modeling and calculations.

Financial interest (all authors)

None

Conflict of interest

All authors certify that they have no affiliation with and no involvement in any organization or entity with any financial interest (such as honoraria; educational grants, participation in speakers, bureaus, membership, employment, consultancies, stock or ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or benefits) in the subject matter or material discussed in this manuscript.

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Rambam Health Care Campus, PO Box 9907, Haifa, 3109901, Israel

    Eedy Mezer, Ewy Meyer & Yaacov Shauly

  2. The Ruth and Bruce Rappaport Faculty of Medicine, Haifa, Israel

    Eedy Mezer & Ewy Meyer

  3. Goldschleger Eye Institute, Chaim Sheba Medical Center at Tel-Hashomer, Ramat-Gan, Israel

    Tamara Wygnansi-Jaffe

  4. Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Tamara Wygnansi-Jaffe

  5. Hamburg University, Hamburg, Germany

    Wolfgang Haase

  6. University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Albert W. Biglan

Authors
  1. Eedy Mezer
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  2. Ewy Meyer
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  3. Tamara Wygnansi-Jaffe
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  4. Wolfgang Haase
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  5. Yaacov Shauly
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  6. Albert W. Biglan
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Corresponding author

Correspondence to Eedy Mezer.

Additional information

Institutions at which the study was conducted include the Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel; Hamburg University, Hamburg, Germany; and the University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.

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Mezer, E., Meyer, E., Wygnansi-Jaffe, T. et al. The long-term outcome of the refractive error in children with hypermetropia . Graefes Arch Clin Exp Ophthalmol 253, 1013–1019 (2015). https://doi.org/10.1007/s00417-015-3033-z

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  • DOI: https://doi.org/10.1007/s00417-015-3033-z

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