Clinical factors associated with moderate hyperopia in preschool children with normal stereopsis and visual acuity

Abstract

A total of 117 children 3-5 years of age with moderate hyperopia in at least one eye, age-normal unaided visual acuity, age-normal stereoacuity, no significant anisometropia or astigmatism, and no strabismus were enrolled in a 3-year randomized clinical trial to compare visual outcomes and ocular alignment in children assigned to immediate glasses or to observation and glasses if deterioration of visual acuity, stereoacuity, or alignment occurred. Pearson correlation coefficients were calculated to evaluate relationships among baseline characteristics. We found a moderate association between higher amounts of uncorrected hyperopia and greater accommodative lag (n = 57; R = 0.31; 95% CI, 0.05-0.53). Higher amounts of hyperopia were weakly associated with worse uncorrected distance visual acuity (n = 117; R = 0.24; 95% CI, 0.06-0.41), and better stereoacuity was weakly associated with better uncorrected near acuity (n = 99; R = 0.24; 95% CI, 0.04-0.42).

FIG 1

Average accommodative lag versus average refractive error (R = 0.31). On average, 1 D more hyperopia is associated with 0.58 D more accommodative lag.

FIG 2

Average monocular distance visual acuity versus refractive error (R = 0.24). On average, 1 D more hyperopia is associated with a reduction in distance visual acuity of 0.02 logMAR. This plot displays two points per child. Distance visual acuity in the right eye was plotted against spherical equivalent refractive error in the right eye; the same plot was performed for the left eye. Analyses are adjusted for age at baseline.

FIG 3

Binocular near visual acuity versus monocular distance visual acuity in the better-seeing eye (R = 0.35) and separately in the poorer-seeing eye (R = 0.34). On average, a reduction in distance visual acuity in either the better-seeing eye or the poorer-seeing eye of 1.0 logMAR is associated with a reduction in binocular visual acuity at near of 0.48 logMAR, adjusting for age at baseline. Binocular near visual acuity was not reported for all subjects. Data was available for 99 of 117 subjects. Reasons for not completing the assessment are not known as this data was not collected.