Correction of Low-Moderate Hyperopia Improves Accommodative Function for Some Hyperopic Children During Sustained Near Work

Abstract

PURPOSE. This study investigated whether refractive correction improved accommodative function of hyperopic children while engaged in two sustained near activities. METHODS.Sustained accommodative function of 63 participants (aged 5-10 years) with varying levels of uncorrected hyperopia (>/= +1.00 D and < + 5.00 D spherical equivalent in the least hyperopic eye) was measured using eccentric infrared photorefraction (PowerRef 3; PlusOptix, Germany). Binocular accommodation measures were recorded while participants engaged in 2 tasks at 25 cm for 15 minutes each: an "active" task (reading small print on an Amazon Kindle), and a "passive" task (watching an animated movie on liquid crystal display [LCD] screen). Participants also underwent a comprehensive visual assessment, including measurement of presenting visual acuity, prism cover test, and stereoacuity. Reading speed was assessed with and without hyperopic correction. Refractive error was determined by cycloplegic retinoscopy. RESULTS.Hyperopic refractive correction significantly improved accuracy of accommodative responses in both task (pairwise comparisons: t = −3.70, P = 0.001, and t = −4.93, P < 0.001 for reading and movie tasks, respectively). Accommodative microfluctuations increased with refractive correction in the reading task (F (1,61) = 25.77, P < 0.001) but decreased in the movie task (F (1,59) = 4.44, P = 0.04). Reading speed also significantly increased with refractive correction (F (1,48) = 66.32, P < 0.001). CONCLUSIONS.Correcting low-moderate levels of hyperopia has a positive impact on accommodative performance during sustained near activity in some schoolchildren. For these children, prescribing hyperopic correction may benefit performance in near vision tasks.

The Impact of Hyperopia on Academic Performance Among Children: A Systematic Review

“…A total of 7 studies explained the cutoff thresholds used to define hyperopia. 12,27,33,53,64,69,74 Four (16.0%) studies used the plus-lens test to identify participants with hyperopia. 12,29,66,71 Three out of these 4 studies, further defined hyperopia using the SE.…”

“…10,27,29,[72][73][74]78 All 4 studies assessing reading speed have reported outcome measures separately; therefore, reading speed was evaluated as a separate domain. 29,53,69,76 Three studies used standardized tests to measure and report reading speed. 29,53,76 Lanc ¸a et al 69 reported the validity of the tool used to assess reading skills and speed.…”

“…33,[64][65][66]68,71,79 Four studies that reported on the impact of hyperopic spectacle correction on academic performance were excluded from the metaanalysis for the following reasons: 1 study did not provide the SD, 29 and the remaining 3 studies could not be pooled to estimate the effect of hyperopic spectacle correction. 10,53,80 Pooled estimates of educational performance from 4 studies with 9551 total participants, ranging in age from 4 to 10 years, showed children with uncorrected hyperopia had worse educational performance than emmetropic children, with a pooled SMD of À0.18 (95% CI, À0.27 to À0.09; P < 0.001) (Fig. 2).…”

“…29,53,69,76 Three studies used standardized tests to measure and report reading speed. 29,53,76 Lanc ¸a et al 69 reported the validity of the tool used to assess reading skills and speed.…”

Application and repeatability of ocular biometric measures for gaze position calibration in children

“…The advent of eye trackers has allowed quantitative estimates of gaze position to be obtained more quickly. Such instruments, particularly those using the displacement of the first‐Purkinje image (PI) (i.e., the separation between the 1st Purkinje image and pupil centre, [PC]) to determine angular units of gaze position in children are being used both in research and clinical practice 2–6 1,7,8 .…”