In an effort to understand how different treatment strategies impact outcomes in young children with uncorrected moderate hyperopia, a team of researchers compared the results of immediately prescribing glasses and delayed treatment with observation. They found either a small to moderate benefit or no benefit at all to immediately prescribing glasses.
This prospective, randomized clinical trial, conducted by the Pediatric Eye Disease Investigator Group, evaluated 130 children ages one to two years with hyperopia between +3.00D and +6.00D. The participants were either prescribed glasses or observed without correction, then followed every six months for three years. They were classified as failing the randomized management regimen if their distance visual acuities or stereoacuities were below age norms, manifest strabismus was observed or strabismus surgery had been performed.
Of the 106 participants that completed the three-year trial, 11 of 53 failed in the glasses group and 18 of 53 failed in the observation group. The study notes that the reasons for failure in the glasses and observation groups were reduced stereoacuities in six and 16, respectively, reduced visual acuities in three and four, respectively, and manifest strabismus in five in each group. Fifty-eight percent of the observation group and 33% of the glasses group met deterioration criteria requiring participants to wear glasses if they did not already. The researchers determined the findings are inconclusive, and require further study.
|Kulp MT, Holmes JM, Dean TW, et al. A randomized clinical trial of immediate versus delayed spectacles for moderate hyperopia in 1- and 2-year olds. Ophthalmology. January 4, 2019. [Epub ahead of print].|