A Randomized Clinical Trial of Immediate Versus Delayed Glasses for Moderate Hyperopia in Children 3 to 5 Years of

Jonathan M Holmes1, Marjean T Kulp2, Trevano W Dean3

  • 1Mayo Clinic, Rochester, Minnesota, USA.

Insights

Early glasses for moderate hyperopia in young children showed no significant difference in visual acuity or binocularity outcomes compared to observation. Low failure rates suggest immediate prescription may not be necessary to prevent vision problems.

Area of Science:

  • Ophthalmology
  • Pediatric Optometry

Background:

  • Moderate hyperopia in young children can impact visual development.
  • Early intervention strategies for hyperopia include glasses prescription or observation.

Purpose of the Study:

  • To compare visual acuity (VA) and binocularity outcomes in children with moderate hyperopia.
  • To evaluate the effectiveness of immediate glasses prescription versus observation in preventing vision deterioration.

Main Methods:

  • A prospective randomized clinical trial (RCT) involving 119 children aged 3-5 years with hyperopia (+3.00D to +6.00D).
  • Children were randomly assigned to receive glasses or observation, with glasses prescribed later if vision deteriorated.
  • Outcomes were assessed over 3 years, defining 'failure' as subnormal VA, stereoacuity, or manifest strabismus.

Main Results:

  • Failure rates were low and similar between groups: 12% for glasses and 9% for observation.
  • No significant difference was found in VA or binocularity outcomes between the two groups.
  • Deterioration requiring glasses occurred in 29% of the glasses group and 27% of the observation group.

Conclusions:

  • In moderately hyperopic children with normal initial VA and binocularity, failure rates were uncommon regardless of early glasses prescription.
  • Due to insufficient enrollment and retention, the study could not definitively determine if immediate glasses reduce failure rates.
  • Low failure rates suggest that immediate glasses prescription may not be essential for preventing VA or binocularity issues in this population.
Abstract

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