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Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Refractive Error

Background:

  • Hyperopic children are at risk for refractive error progression.
  • Accommodative esotropia (AE) is a common condition in childhood that can affect refractive development.
  • The impact of AE on refractive error changes in hyperopic children with minimal undercorrection requires further investigation.

Purpose of the Study:

  • To compare changes in spherical equivalent refractive error (SER) and axial length (AL) over three years.
  • To investigate these changes in hyperopic children with minimal undercorrection.
  • To determine if the presence of accommodative esotropia (AE) influences these changes.

Main Methods:

  • Sixty-seven hyperopic children were divided into three age-matched groups: esotropic eyes with AE, fellow eyes with AE, and eyes without esotropia.
  • Spherical equivalent refractive error (SER) and axial length (AL) were measured every six months for three years.
  • Changes in SER and AL were compared among the three groups.

Main Results:

  • All groups experienced myopic shift and axial length elongation.
  • The AE group exhibited significantly less SER change (-0.96 ± 1.38D) compared to the HE group (-1.76 ± 1.11D) and FE group (-1.57 ± 1.33D) (p<0.001).
  • The AE group also showed smaller AL changes (0.62 ± 0.88mm) compared to the HE group (0.99 ± 0.29mm; p<0.001) and FE group (0.73 ± 0.65mm; p=0.04).

Conclusions:

  • Hyperopic children with AE and minimal undercorrection demonstrated reduced SER myopic shift and AL elongation.
  • These changes were less pronounced compared to hyperopic eyes without AE and fellow eyes with AE.
  • AE may have a protective effect against refractive error progression in this population.