Glasses show no advantage in managing hyperopia in young children
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Eyeglasses wear showed no major efficacy compared with observation in treating young children diagnosed with hyperopia, according to findings published in Ophthalmology.
Marjean T. Kulp, OD, MS, and colleagues compared whether the use of immediate prescription of glasses or observation without glasses was a more effective approach in managing moderate hyperopia in young children.
“Previous studies comparing partial correction with no glasses for moderate hyperopia have reported conflicting results regarding whether or not prescription of glasses influences the development of manifest strabismus or amblyopia,” Kulp of The Ohio State University College of Optometry, and colleagues wrote. “Furthermore, these studies suffered potential sources of bias, such as lack of masking, high loss to follow-up and unclear handling of missing data.”
The researchers analyzed data from a prospective randomized clinical trial involving children 1 to 2 years old diagnosed with hyperopia and a spherical equivalent (SE) between 3.00 D and 6.00 D in at least one eye, anisometropia less than or equal to 1.50 D SE and astigmatism less than or equal to 1.50 D based on cycloplegic refraction and no manifest strabismus.
They stratified participants into two groups, one wearing glasses and one that received observation over 6 months during a 3-year span. In the observation group, glasses were provided if criteria for deterioration of distance visual acuity, near stereoacuity below age norms or development of manifest strabismus were met.
Main outcomes were failure of regimen as a result of distance visual acuity or stereoacuity declining below age norms, the observed presence of manifest strabismus or if strabismus surgery was performed, the researchers wrote.
Kulp and colleagues identified that of the 106 participants who completed the 3-year primary outcome examination, the failure rate was lower in the glasses group compared with the observational group (21% vs 34%; difference of –13%; 95% CI, –31 to 4). In relation to deterioration criteria, the observational group had a rate of 62% (95% CI, 49-74) compared with 34% in the glasses group (95% CI, 23-48), the researchers wrote.
“Regardless of initial treatment approach, the moderate-to-high proportion of deterioration and subsequent moderate proportion of failure at 3 years indicate the need for eye care professionals to closely follow children aged 1 to 2 years with moderate hyperopia,” Kulp and colleagues wrote.
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