Non-cycloplegic refractive screening can identify infants whose visual outcome at 4 years is improved by spectacle...

Area of Science:

• Ophthalmology
• Developmental Pediatrics
• Public Health

Background:

• Infant vision screening programs aim to detect refractive errors that may lead to amblyopia or strabismus.
• The Second Cambridge Population Infant Vision Screening Programme utilized videorefractor technology without cycloplegia.

Purpose of the Study:

• To evaluate the long-term visual acuity and strabismus outcomes in infants identified with refractive errors.
• To assess the impact of spectacle correction on visual development in hyperopic infants.

Main Methods:

• Infants identified with refractive errors at eight months were enrolled in a treatment trial with partial spectacle correction.
• Visual acuity and strabismus were monitored through long-term follow-up.
• Poor acuity was defined as best-corrected acuity of 6/12 or worse (crowded) or 6/9 or worse (single letters) at age 4 years.

Main Results:

• Untreated hyperopic infants had significantly poorer visual acuity outcomes compared to controls and those compliant with spectacle wear.
• Significantly hyperopic infants were more likely to develop strabismus by 5.5 years compared to emmetropic controls.
• Children not refractively corrected for hyperopia were four times more likely to have poor acuity at 5.5 years than those wearing correction.

Conclusions:

• Early detection and correction of significant hyperopia in infancy are crucial for optimal visual acuity development.
• While hyperopia increases strabismus risk, this study did not find a significant difference in strabismus incidence between corrected and uncorrected hyperopic infants.
• Findings support the efficacy of infant vision screening and timely intervention with spectacle correction.