Prevalence of hyperopia and associations with eye findings in 6- and 12-year-olds

To describe the prevalence of hyperopia and associated factors in a representative sample of Australian schoolchildren 6 and 12 years old.

Population-based cross-sectional study.

Schoolchildren ages 6 (n = 1765) and 12 (n = 2353) from 55 randomly selected schools across Sydney.

Detailed eye examinations included cycloplegic autorefraction, ocular biometry, cover testing, and dilated fundus examination. Information on birth and medical history were obtained from a parent questionnaire.

Moderate hyperopia defined as spherical equivalent (SE) refraction of > or =+2.00 diopters (D), and eye conditions including amblyopia, strabismus, astigmatism, and anisometropia.

Prevalences of moderate hyperopia among children ages 6 and 12 were 13.2% and 5.0%, respectively; it was more frequent in children of Caucasian ethnicity (15.7% and 6.8%, respectively) than in children of other ethnic groups. Compared with children without significant ametropia (-0.49 < or = SE refraction < or = +1.99 D), the prevalence of eye conditions including amblyopia, strabismus, abnormal convergence, and reduced stereoacuity was significantly greater in children with moderate hyperopia (all Ps < 0.01). Maternal smoking was significantly associated with moderate hyperopia among 6-year-olds (P = 0.03), but this association was borderline among 12-year-olds (P = 0.055). Early gestational age (<37 weeks) and low birth weight (<2500 g) were not statistically significant predictors of moderate hyperopia in childhood.

Moderate hyperopia was strongly associated with many common eye conditions, particularly amblyopia and strabismus, in older children. Birth parameters did not predict moderate hyperopia.