Refractive error change and vision improvement in moderate to severe hyperopic amblyopia after spectacle correction: Restarting the emmetropization process?

Abstract

PurposeThe aims of the study were to develop guidelines for prescribing spectacles for patients with moderate to severe hyperopic amblyopia and to demonstrate how emmetropization progresses.MethodsChildren with hyperopic amblyopia who had a spherical equivalent of ≥ +4.0 diopters (D) or more were included, while those who had astigmatism of > 2.0 D or anisometropia of > 2.0 D were excluded. The patients were divided into a full correction group and an under-correction group according to the amount of hyperopia correction applied. The under-correction group was further subdivided into a fixed under-correction group and a post-cycloplegic refraction (PCR) under-correction group. The duration of amblyopia treatment and changes in initial hyperopia were compared between the groups.ResultsIn total, 76 eyes of 38 patients were analyzed in this study. The full correction group and under-correction group were subjected to 5.5 months and 5.9 months of amblyopia treatment, respectively (P = 0.570). However, the PCR under-correction group showed more rapid improvement (2.9 months; P = 0.001). In the under-correction group, initial hyperopia was decreased by -0.28 D and -0.49 D at 6 months and 12 months, respectively, after initial cycloplegic refraction. Moreover, the amount of hyperopia under-correction was correlated with the amount of hyperopia reduction (P = 0.010).ConclusionThe under-correction of moderate to severe hyperopic amblyopia has beneficial effects for treating amblyopia and activating emmetropization. PCR under-correction can more rapidly improve visual acuity, while both fixed under-correction and PCR under-correction can induce emmetropization and effectively reduce initial hyperopia.

Current scenario of refractive accommodative esotropia management in a tertiary eye care center: A retrospective study

“…According to research, esotropes may act differently in terms of emmetropization (16). Many studies state that wearing an appropriate optical correction may prevent emmetropization (17,18). Our results support the idea that wearing hyperopic spectacles prevents emmetropization in esotropes.…”

Optical treatment of amblyopia: a systematic review and meta‐analysis

“…Four of the nine studies investigated binocular amblyopia due to high iso‐ametropia in ages ranging from three to 14 years . In three studies, resolution of amblyopia was found in 28–74 per cent of subjects, while one study did not report a resolution rate.…”

An accuracy study of the AL/CR ratio in assessing different degrees of hyperopia in children aged 3-6 years

“…Donahue SP et al have shown a correlation between uncorrected moderate hyperopia and measurement of visual perception and visual-motor integration as well as deficits in sustained attention [24], and other studies have pointed out that the early refractive correction of children with moderate hyperopia can improve the regulation of near sustained eye use [25]. Even Chang JW has pointed out that early correction of hyperopia is more beneficial for the emmetropization of preschool children [26],…”