Related Experiment Video
Updated: Apr 26, 2026
Binocular Dynamic Visual Acuity in Eyeglass-Corrected Myopic Patients
Published on: March 29, 2022
Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic
D Somer1, E Karabulut1, F G Cinar1
1Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
Insights
Infants with hyperopia who had normal binocular accommodation did not develop strabismus. Partial correction based on dynamic retinoscopy (DR) did not hinder emmetropization or visual acuity in hyperopic infants.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Vision Science
Background:
- Hyperopia is common in infants and can impact visual development.
- Early detection and management of hyperopia are crucial for preventing strabismus and amblyopia.
- Dynamic retinoscopy (DR) offers a method to assess accommodative function in infants.
Purpose of the Study:
- To evaluate emmetropization, visual acuity, and strabismus outcomes in hyperopic infants.
- To assess the effect of partial hyperopic corrections based on DR on visual development.
- To identify early indicators of strabismus risk in infants with hyperopia.
Main Methods:
- Followed 211 infants (3.5-12 months) with ≥5D hyperopia.
- Prescribed partial hyperopic corrections based on near dynamic accommodative abilities (DR).
- Monitored refraction, binocular accommodation, and visual acuity over a mean of 35.4 months.
Main Results:
- Infants with normal initial accommodation (Group 1) did not develop strabismus.
- 48% of hypo-accommodating infants (Group 2) developed strabismus despite partial correction.
- All groups showed a reduction in hyperopia; Groups 1 and 2A achieved normal visual acuity.
Conclusions:
- Initial binocular accommodative behavior is an indicator for strabismus and amblyopia risk.
- DR-based partial corrections do not impede emmetropization or visual acuity in hyperopic infants.
- Early assessment of accommodation is vital for predicting visual outcomes in infants.
Object:
To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR).
Methods:
Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period.
Results:
Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31 (48%) developed strabismus (Group 2B). The remaining 34 constituted Group 2A. Each of the three groups showed an overall reduction of hyperopia by 0.37±0.25 days per year, 0.50±0.28 days per year, and 0.60±0.20 days per year, respectively. Visual acuity assessments among Groups 1 and 2A revealed normal values (0.2-0.0 LogMAR); among Group 2B 19% were within normal range.
Conclusions:
Binocular accommodative behavior at the initial visit seems to be one of the indicators for pointing out infants at risk of developing strabismus and amblyopia. Prescription of DR-based corrections to hyperopic orthotropic infants does not impede emmetropization and result in normal visual acuities after emmetropization period.
