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. 2023 May 1;100(5):304-311.
doi: 10.1097/OPX.0000000000002011. Epub 2023 Mar 23.

Evaluation of a Pilot Protocol for Detecting Infant Hyperopia

Ann M Morrison, Donald O Mutti  1
Affiliations

Evaluation of a Pilot Protocol for Detecting Infant Hyperopia

Ann M Morrison et al. Optom Vis Sci. .

Abstract

Significance: Highly hyperopic children are at greater risk for developing conditions such as strabismus, amblyopia, and early literacy and reading problems. High hyperopia is a common finding in infants in a pediatric medical practice, and early detection can be done effectively in that setting with tropicamide autorefraction.

Purpose: This study aimed to evaluate the effectiveness of a pilot screening program to detect high hyperopia in 2-month-old infants in a pediatric medical practice in Columbus, Ohio.

Methods: Cycloplegic refractive error (1% tropicamide) was measured by retinoscopy and autorefraction with the Welch Allyn SureSight (Welch Allyn/Hillrom, Skaneateles Falls, NY) in 473 infants (55.4% female) who were undergoing their 2-month well-baby visit at their pediatrician's medical practice. Cycloplegic retinoscopy (1% cyclopentolate) was repeated at a subsequent visit in 35 infants with ≥+5.00 D hyperopia in the most hyperopic meridian during the screening.

Results: Twenty-eight infants (5.9%) had high hyperopia (spherical equivalent, ≥+5.00 D), and 61 (12.9%) had high hyperopia (≥+5.00 D in at least one meridian of at least one eye) by retinoscopy with 1% tropicamide. The mean ± standard deviation spherical equivalent tropicamide cycloplegic refractive error measured with retinoscopy was +2.54 ± 1.54 D (range, -3.25 to +7.00 D) and with SureSight was +2.29 ± 1.64 D (range, -2.90 to +7.53 D). Retinoscopy done using 1% cyclopentolate was 0.44 ± 0.54 D more hyperopic in spherical equivalent than with 1% tropicamide ( P < .001).

Conclusions: High hyperopia was a common finding in 2-month-old infants in a pediatric medical setting that could be detected effectively by cycloplegic autorefraction using tropicamide. Greater cooperation between pediatric primary vision and medical care could lead to effective vision screenings designed to detect high hyperopia in infants.

Trial registration: ClinicalTrials.gov NCT03669146.

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Conflict of interest statement

Conflict of Interest Disclosure: AMM has no reported financial conflicts of interest. DOM is a consultant for Vyluma, Inc.

References

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    1. Kleinstein RN, Jones LA, Hullett S, et al. Refractive Error and Ethnicity in Children. Arch Ophthalmol 2003;121:1141–7.
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    1. Anker S, Atkinson J, Braddick O, et al. Non-cycloplegic Refractive Screening Can Identify Infants Whose Visual Outcome at 4 Years Is Improved by Spectacle Correction. Strabismus 2004;12:227–45.
    1. Cotter SA, Varma R, Tarczy-Hornoch K, et al. Risk Factors Associated with Childhood Strabismus: The Multi-Ethnic Pediatric Eye Disease and Baltimore Pediatric Eye Disease Studies. Ophthalmology 2011;118:2251–61.

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