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To emmetropize or not to emmetropize? The question for hyperopic development

Donald O Mutti1

  • 1The Ohio State University College of Optometry, Columbus, Ohio, USA.

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|February 15, 2007
PubMed

Insights

Early childhood hyperopia can impact vision. Correcting hyperopia in children may improve visual acuity and accommodation, and clinicians

Area of Science:

  • Ophthalmology
  • Pediatric Optometry
  • Developmental Biology

Background:

  • Emmetropization is a rapid developmental process primarily occurring within the first year of life.
  • A significant percentage of children (2-8%) may experience clinically relevant hyperopia post-infancy due to failed emmetropization.
  • Uncorrected hyperopia in childhood can negatively affect distance visual acuity and accommodative response accuracy.

Purpose of the Study:

  • To evaluate the impact of uncorrected hyperopia on visual performance in children.
  • To determine the clinical significance of hyperopic refractive errors in early childhood.
  • To assess the benefits of refractive correction for improving visual acuity and accommodation in children with hyperopia.

Main Methods:

  • Analysis of refractive error data in infants and children.
  • Assessment of distance visual acuity and accommodative response accuracy.
  • Review of clinical practices regarding hyperopic correction in pediatric populations.

Main Results:

  • A refractive error threshold around +2.00 to +3.00 D may indicate potential visual problems in children.
  • Prescribing refractive corrections appears to enhance distance acuity and accommodative accuracy.
  • Concerns about interfering with natural emmetropization may be unwarranted given potential visual benefits.

Conclusions:

  • The immediate visual benefits of correcting hyperopia in children may outweigh concerns about interfering with the emmetropization process.
  • Clinicians should reconsider reluctance to prescribe hyperopic corrections if emmetropization is incomplete or ineffective.
  • Early intervention with refractive correction can potentially mitigate negative impacts on visual development.

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