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Emmetropisation and accommodation in hypermetropic children before they show signs of squint--a preliminary analysis
R M Ingram1, L E Gill, M J Goldacre
1Kettering General Hospital.
Insights
Children with convergent squint or microtropia showed less hypermetropia reduction and more accommodation issues. These visual system defects were present early, impacting both eyes before diagnosis.
Area of Science:
- Ophthalmology
- Developmental Pediatrics
- Pediatric Optometry
Background:
- Hypermetropia is common in infants and often resolves spontaneously.
- Squint (strabismus) and microtropia are common visual disorders in children.
- Accommodation refers to the eye's ability to change focus.
Purpose of the Study:
- To investigate refractive changes and accommodation in hypermetropic children.
- To identify early indicators of visual system defects in children who develop squint or microtropia.
- To explore the relationship between refractive development, accommodation, and the onset of strabismus or microtropia.
Main Methods:
- Longitudinal follow-up of 1119 hypermetropic children from 6 months to 3.5 years.
- Assessment of changes in refractive error (hypermetropia).
- Evaluation of the accommodative function in both eyes.
Main Results:
- Children who developed convergent squint or microtropia were less likely to show spontaneous reduction of hypermetropia.
- These children also exhibited a higher incidence of accommodative problems.
- Visual system abnormalities were observed in both fixing and non-fixing eyes, with no significant difference between microtropia and squint groups.
Conclusions:
- A fundamental defect in visual system function or development likely precedes the diagnosis of squint or microtropia.
- This defect affects both eyes, impacting refractive development and accommodation.
- The origin of this defect (congenital vs. acquired) requires further investigation.
Abstract:
1119 hypermetropic children have been followed from the age of 6 months to 3 1/2 years. Observations are reported on (i) the changes in their refraction and (ii) their accommodation. Children who eventually had either a convergent squint or a microtropia were significantly (i) less likely to have spontaneously reduced their hypermetropia, and (ii) more likely to have problems with their accommodation, than those who had no squint. These abnormalities were demonstrated in both the fixing and the non-fixing eyes. There was no obvious difference between the findings for children who had microtropia and squint. We suggest that there was a basic defect in the function, and/or the development, of the visual systems relating to both fixing and non-fixing eyes of children who had squint or microtropia; and that this defect was present before squint or microtropia were diagnosed. The question of whether this defect had a congenital or an acquired (form vision deprivation) cause is discussed.