Does hyperopic correction worsen exotropia? A retrospective comparison in Children with high hyperopia

This study aimed to evaluate the effect of refractive correction on ocular deviation in children with exotropia and high hyperopia, and to compare treatment outcomes between partial and full hyperopic correction. The main objective was to evaluate if complete hyperopic correction leads to worsening of exotropia in comparison to partial correction.

This retrospective study included 43 patients diagnosed with high hyperopia (≥ + 3.00 D) and exotropia (≥ 10 prism diopters). Patients were categorized into two groups based on the level of spectacle correction: Group 1 received partial correction and Group 2 received full correction. Statistical analysis was conducted to compare best-corrected visual acuity (BCVA), amblyopia, and the degree of exotropia deviation.

The average age at first admission and the follow-up duration were 6.3 (± 3.1) years and 3.7 (± 3.0) years, respectively. Before spectacle correction, the mean visual acuity was 0.45 ± 0.28; it increased to 0.63 ± 0.31 after treatment (p < 0.001). Additionally, the number of patients diagnosed with amblyopia significantly decreased (p = 0.001). Twenty-seven patients received partial correction, while sixteen were treated with full correction. Although a slight reduction in exodeviation was observed, there were no statistically significant differences in the overall population or within any of the subtypes (constant exotropia and intermittent exotropia) when comparing deviation angles between the partial and full correction groups before and after treatment (p > 0.05).

Refractive correction is essential for improving visual acuity and reducing amblyopia in children with exotropia and significant hyperopia. Our results suggest that the use of high hyperopic spectacle correction did not demonstrate worsening of exotropia in this cohort.