The Clinical Characteristics of Hypermetropia in Children

Purpose : It is generally believed that children with uncorrected hypermetropia are at risk for the development of unilateral or bilateral amblyopia and for the development of esotropia. We were, therefore, interested in the clinical manifestation in Korean children with hypermetropia. Methods : We included the children with bilateral hypermetropia of greater than or equal to 3 diopters (D) by spherical equivalent. On the basis of initial visual acuity, children were divided into 3 groups: monocular amblyopia, binocular amblyopia, and normal visual acuity. All children were also divided into 2 groups: esotropia and orthotropia. We investigated the influences of factors such as age at initial visit, incidence of amblyopia, esotropia, anisometropia, degree of hypermetropia and anisometropia between each group. Results : Of 50 children, there was only one child with normal visual acuity in both eyes as well as orthotropia. There was more marked difference in the degree of hypermetropia between both eyes in monocular amblyopic group (n=28) than binocular amblyopic group (n=13) (0.91:0.46 D, p=0.01). The age at initial visit was the most important parameter between esotropia (n=40) and orthotropia (n=8) (3.67:5.75 years, p=0.01). Otherwise, there were no significant parameters between each group. Conclusions : Forty-nine of 50 children (98.0%) had unilateral or bilateral amblyopia and/or esotropia. Initial visit was especially delayed in the children without esotropia. Therefore, we recommend the preschool vision screening examinations and optical correction at an early age. In any case with hypermetropia, they should be closely observed to prevent developement of amblyopia or esotropia.