title: Emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy.
abstract: OBJECTIVE
  To record emmetropization, visual acuity, and strabismus outcomes among hyperopic infants followed with partial hyperopic corrections given in accordance with dynamic retinoscopy (DR).
  
  
  METHODS
  Infants (3.5-12 months of age) with ≥5 D hyperopia were followed without glasses or partial hyperopic corrections prescribed according to their near dynamic accommodative abilities determined by DR responses at the initial visit and follow-ups. Refraction and binocular accommodative ability assessments were made at 3-month intervals up to the age of 1 and at 6-month intervals afterwards for a mean 35.4±2.1 months; main outcome measures being the development of esotropia, emmetropization rate, and visual acuity level after emmetropization period.
  
  
  RESULTS
  Among 211, 146 were normal accommodators initially (Group 1). These infants were followed without treatment and none presented with strabismus. Sixty-five infants were hypo-accommodators (Group 2) and received minimum DR-based corrections. Of the 65 infants 31 (48%) developed strabismus (Group 2B). The remaining 34 constituted Group 2A. Each of the three groups showed an overall reduction of hyperopia by 0.37±0.25 days per year, 0.50±0.28 days per year, and 0.60±0.20 days per year, respectively. Visual acuity assessments among Groups 1 and 2A revealed normal values (0.2-0.0 LogMAR); among Group 2B 19% were within normal range.
  
  
  CONCLUSIONS
  Binocular accommodative behavior at the initial visit seems to be one of the indicators for pointing out infants at risk of developing strabismus and amblyopia. Prescription of DR-based corrections to hyperopic orthotropic infants does not impede emmetropization and result in normal visual acuities after emmetropization period.
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: D
authors.initials: D
authors.lastname: Somer
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: E
authors.initials: E
authors.lastname: Karabulut
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: F G
authors.initials: FG
authors.lastname: Cinar
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: U E
authors.initials: UE
authors.lastname: Altiparmak
authors.affiliation: Department of Pediatric Ophthalmology and Strabismus, S.B. Ankara Education and Research Hospital, Ankara, Turkey.
authors.forename: N
authors.initials: N
authors.lastname: Unlu
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology; D058453:Emmetropia / Q000502:physiology*; D004948:Esotropia / Q000503:physiopathology*; D005139:Eyeglasses; D005500:Follow-Up Studies; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology / Q000628:therapy*; D007223:Infant; D012029:Refraction, Ocular / Q000502:physiology; D042262:Retinoscopy; D015348:Vision, Binocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology*