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Associations between Hyperopia and other Vision and Refractive Error Characteristics #MMPMID24637486
Kulp MT; Ying Gs; Huang J; Maguire M; Quinn G; Ciner EB; Cyert LA; Orel-Bixler DA; Moore BD
Optom Vis Sci 2014[Apr]; 91 (4): 383-9 PMID24637486show ga
Purpose: To investigate the association of hyperopia >+3.25D with amblyopia, strabismus, anisometropia, astigmatism, and reduced stereoacuity in preschoolers. Methods: 3- to 5-year old Head Start preschoolers (n=4040) underwent vision examination including monocular visual acuity (VA), cover testing, and cycloplegic refraction during the Vision In Preschoolers (VIP) study. VA was tested with habitual correction, and was retested with full cycloplegic correction when VA was reduced below age norms in the presence of significant refractive error. Stereoacuity testing (Stereo Smile II) was performed on 2898 children during study years 2 and 3. Hyperopia was classified into 3 levels of severity (based upon most positive meridian on cycloplegic refraction): Group 1:?+5.00D, Group 2:>+3.25D to <+5.00D with interocular difference (IOD) in spherical equivalent (SE) ?0.50D, and Group 3:>+3.25D to <+5.00D with IOD in SE<0.50D. ?Without? hyperopia was defined as refractive error of +3.25 D or less in the most positive meridian in both eyes. Standard definitions were applied for amblyopia, strabismus, anisometropia, and astigmatism. Results: Relative to children without hyperopia, children with hyperopia >+3.25D (N=472, Groups 1, 2, 3) had a higher proportion of amblyopia (34.5% vs. 2.8%, p<0.0001) and strabismus (17.0% vs. 2.2%, p<0.0001). More severe levels of hyperopia were associated with higher proportions of amblyopia (51.5% in Group 1 vs 13.2% in Group 3) and strabismus (32.9% in Group 1 vs 8.4% in Group 3; trend p<0.0001 for both). Presence of hyperopia >+3.25D also was associated with a higher proportion of anisometropia (26.9% vs. 5.1%, p<0.0001) and astigmatism (29.4% vs. 10.3%, p<0.0001). Median stereoacuity of non-strabismic, non-amblyopic children with hyperopia (N=206) (120?) was worse than that of children without hyperopia (60?) (p<0.0001) and more severe levels of hyperopia were associated with worse stereoacuity (480? for Group 1, 120? for Groups 2 and 3, p<0.0001). Conclusions: The presence and magnitude of hyperopia among preschoolers was associated with higher proportions of amblyopia, strabismus, anisometropia, astigmatism and with worse stereoacuity even among non-strabismic, non-amblyopic children.
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Optom+Vis+Sci 2014 ; 91 (4): 383-9
