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Results of a randomised trial of treating abnormal hypermetropia from the age of 6 months
R M Ingram1, P E Arnold, S Dally
1Kettering District General Hospital, Northants.
Insights
Early spectacle correction for infantile hypermetropia did not prevent squint. Consistent glasses wear in children may improve visual acuity, potentially preventing severe amblyopia.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Strabismus Research
Background:
- Infantile hypermetropia is a refractive error present in young children.
- Early detection and intervention for refractive errors are crucial for visual development.
- The relationship between hypermetropia, spectacle correction, and the development of squint and amblyopia requires further investigation.
Purpose of the Study:
- To determine if early optical correction of hypermetropia in infants prevents squint and amblyopia.
- To assess the impact of consistent spectacle wear on visual outcomes in children with hypermetropia.
Main Methods:
- Randomized controlled trial involving infants aged 6 months with significant hypermetropia.
- Participants were allocated to either spectacle treatment or no treatment groups.
- Subgroup analysis based on consistent spectacle wear versus inconsistent or no wear.
Main Results:
- No significant difference in the incidence of squint (approximately 24%) between the treatment and no-treatment groups.
- Visual acuity outcomes were not significantly different between the main groups.
- Within the treatment group, consistent spectacle wear showed a trend towards better visual acuity compared to inconsistent wear.
Conclusions:
- Routine screening and optical correction of infantile hypermetropia are not indicated to prevent squint or amblyopia.
- Consistent spectacle wear in children with hypermetropia may play a role in preventing severe amblyopia.
- Further research is warranted to explore the long-term visual benefits of consistent correction in pediatric populations.
Abstract:
Children who were abnormally hypermetropic at the age of 6 months were randomly allocated treatment with spectacles or no treatment. The eventual incidence of squint was the same in both groups (approximately 24%). The last known visual acuity of the two groups was not significantly different either. Therefore there is no indication to screen infants with a view to preventing squint/amblyopia by optical correction of hypermetropia. If, however, the children allocated treatment are divided into two subgroups--those who wore glasses consistently and those who probably or certainly did not do so--the incidence of squint was the same, but the last known acuities of those who consistently wore glasses may be better than those who did not do so. This suggests that it may yet prove possible to prevent severe amblyopia.