The Long-term Outcome of the Refractive Error in Children with Hypermetropia

Purpose: The purpose of this study was to investigate the long-term outcome of high hypermetropic refractive errors in childhood.

Methods: We retrospectively reviewed data from the clinical records of 164 children with spherical equivalent (SE) hypermetropic refractive errors in three medical centers collected over 29 years. Refractive errors between +1.00 and +3.00 diopter (D) on initial examination were classified as mild hypermetropia and those +5.00 D or greater were classified as high hypermetropia. The four variables studied were, age, refractive error, strabismus, and gender. The rate of reduction in hypermetropic refractive error was calculated over time in years. We identified subgroups according to age, gender, and initial refractive error.

Results: Seventy-eight children with high hypermetropia and 86 children with mild hypermetropia were studied. High hypermetropia was detected at a mean age of 3.3 years, while mild hypermetropia was detected at a mean 4 years of age. The mean follow-up was 6.6 years for high hypermetropia and 6.4 years for mild hypermetropia. Over the follow-up period, children in all subgroups tended to reduce their refractive errors. The reduction in refraction power was small for both mild and high hypermetropic refractive errors. Amblyopia in the high hypermetropia group was more common and more refractory to treatment.

Conclusions: Most children with hypermetropia of less than +3.00 D experience a reduction in hyperopic refractive error over time and will outgrow any need for corrective lenses. Children with hyperopia greater than +5.00 D will not experience a significant reduction in the power of the refractive error.