New data from the Pediatric Eye Disease Investigator Group suggests moderately hyperopic children ages three to five with normal visual acuity and binocularity may not need a glasses prescription right away.1 The results come on the heels of similar findings for children ages one to two.2
The researchers from 12 different colleges and eye care centers in the United States enrolled 119 patients between the ages of three and five who had hyperopia between +3.00D and a +6.00D spherical equivalent. The study randomly assigned the children into glasses or observation only. The children in the observation group were prescribed glasses if their vision deteriorated during the investigation. Researchers followed them every six months; the treatment strategy was defined as “failed” at three years if a child had any of the following with or without correction: subnormal distance visual acuity or stereoacuity; manifest strabismus; or strabismus surgery since they were first enrolled in the study.1
The randomized clinical trial found that of the 84 patients (71%) who completed the primary outcome exam, 12% of the children who were prescribed glasses failed and 9% failed in the observation group. Also of note: 29% of the kids who were in the glasses group and 27% in the observation group experienced visual deterioration prior to the three year study endpoint.1
Although visual acuity or binocularity failure wasn’t common in either group, the study did report some limitations.1
“With insufficient enrollment and retention, our study was unable to determine whether immediate glasses prescription reduces failure rate, but low failure rates suggest immediate glasses prescription for these children may not be needed to prevent failure for visual acuity and/or binocularity,” the researchers wrote in their paper.1
1. Holmes JM, Kulp MT, Dean TW, et al. A randomized clinical trial of immediate versus delayed glasses for moderate hyperopia in children three to five years of age. Am J Ophthalmol. June 27, 2019. (Epub ahead of print).
2. 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].