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Normal emmetropization in infants with spectacle correction for hyperopia
J Atkinson1, S Anker, W Bobier
1Visual Development Unit, London and Cambridge, Department of Psychology, University College London, United Kingdom. j.atkinson@ucl.ac.uk
Insights
Partial spectacle correction in infants with hyperopia did not impede emmetropization. This study found that visual development and refractive error reduction occurred similarly in treated and untreated groups, showing benefits without harm.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Developmental Optics
Background:
- Emmetropization, the process of refractive error development, is influenced by visual input.
- Partial spectacle correction in infants can help reduce strabismus and amblyopia.
- The impact of partial spectacle correction on infant emmetropization remains unclear.
Purpose of the Study:
- To conduct the first longitudinal controlled trial investigating whether partial spectacle correction impedes emmetropization in infants.
- To assess the effects of partial spectacle correction on refractive development in infants with hyperopia.
Main Methods:
- A longitudinal controlled trial involving 148 infants aged 8-9 months with significant hyperopia.
- Infants were assigned to either a partial spectacle correction group or an untreated group. A control group of infants without refractive errors was also included.
- Cycloplegic retinoscopy was performed every 4-6 months until 36 months of age to track refractive changes.
Main Results:
- Hyperopia decreased in both treated and untreated hyperopic groups between 9 and 36 months.
- No significant difference in hyperopia reduction was observed between the partially corrected and uncorrected groups by 36 months.
- Both hyperopic groups maintained higher mean refractive errors than the control group at 36 months.
Conclusions:
- Partial spectacle correction for infants with hyperopia does not hinder the natural process of emmetropization.
- The therapeutic benefits of spectacle correction for infantile hyperopia can be realized without negatively impacting refractive development.
Purpose:
The development of emmetropic refraction is known to be under visual control. Does partial spectacle correction of infants' refractive errors, which has been shown to have beneficial effects in reducing strabismus and amblyopia, impede emmetropization? The purpose of the present study was to perform the first longitudinal controlled trial to investigate this question in human subjects.
Methods:
Children identified as having significant hyperopia in a population screening program at age 8 to 9 months were assigned to treated (partial spectacle correction) or untreated groups. A control group of infants with no significant refractive errors at screening was also recruited. Measurements of retinoscopic refraction under cycloplegia were taken at 4- to 6-month intervals up to the age of 36 months, and changes in refraction of 148 subjects were analyzed longitudinally.
Results:
Refractive error decreased toward low hyperopic values between 9 and 36 months in both hyperopic groups. By 36 months, this reduction of hyperopia showed no overall difference between children who were treated with partial spectacle correction and those who were not. Despite the improvement, both hyperopic groups' mean refractive error at 36 months remained higher than that of the control group. When infants in all three groups were considered together, the rate of reduction of refractive error was, on average, a linear function of the initial level of hyperopia.
Conclusions:
The benefits of spectacle correction for infants with hyperopia can be achieved without impairing the normal developmental regulation of refraction.