title: Visual Function of Moderately Hyperopic 4- and 5-Year-Old Children in the Vision in Preschoolers - Hyperopia in Preschoolers Study.
abstract: OBJECTIVE
  To compare visual performance between emmetropic and uncorrected moderately hyperopic preschool-age children without strabismus or amblyopia.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  setting: Multicenter, institutional. patient or study population: Children aged 4 or 5 years. intervention or observation procedures: Visual functions were classified as normal or reduced for each child based on the 95% confidence interval for emmetropic individuals. Hyperopic (≥3.0 diopters [D] to ≤6.0 D in the most hyperopic meridian; astigmatism ≤1.50 D; anisometropia ≤1.0 D) and emmetropic status were determined by cycloplegic autorefraction.
  
  
  METHODS
  Uncorrected monocular distance and binocular near visual acuity (VA); accommodative response; and near random dot stereoacuity.
  
  
  RESULTS
  Mean (± standard deviation) logMAR distance visual acuity (VA) among 248 emmetropic children was better than among 244 hyperopic children for the better (0.05 ± 0.10 vs 0.14 ± 0.11, P < .001) and worse eyes (0.10 ± 0.11 vs 0.19 ± 0.10, P < .001). Mean binocular logMAR near VA was better in emmetropic than in hyperopic children (0.13 ± 0.11 vs 0.21 ± 0.11, P < .001). Mean accommodative response for emmetropic children was lower than for hyperopic subjects for both Monocular Estimation Method (1.03 ± 0.51 D vs 2.03 ± 1.03 D, P < .001) and Grand Seiko (0.46 ± 0.45 D vs 0.99 ± 1.0 D, P < .001). Median near stereoacuity was better in emmetropic than in than hyperopic children (40 sec arc vs 120 sec arc, P < .001). The average number of reduced visual functions was lower in emmetropic than in hyperopic children (0.19 vs 1.0, P < .001).
  
  
  CONCLUSIONS
  VA, accommodative response, and stereoacuity were significantly reduced in moderate uncorrected hyperopic preschool children compared to emmetropic subjects. Those with higher hyperopia (≥4 D to ≤6 D) were at greatest risk, although more than half of children with lower magnitudes (≥3 D to <4 D) demonstrated 1 or more reductions in function.
authors.affiliation: Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania. Electronic address: Eciner@salus.edu.
authors.forename: Elise B
authors.initials: EB
authors.lastname: Ciner
authors.affiliation: The Ohio State University College of Optometry, Columbus, Ohio.
authors.forename: Marjean Taylor
authors.initials: MT
authors.lastname: Kulp
authors.affiliation: University of Pennsylvania, Center for Preventive Ophthalmology & Biostatistics, Philadelphia, Pennsylvania.
authors.forename: Maureen G
authors.initials: MG
authors.lastname: Maguire
authors.affiliation: University of Pennsylvania, Center for Preventive Ophthalmology & Biostatistics, Philadelphia, Pennsylvania.
authors.forename: Maxwell
authors.initials: M
authors.lastname: Pistilli
authors.affiliation: Indiana University School of Optometry, Bloomington, Indiana.
authors.forename: T Rowan
authors.initials: TR
authors.lastname: Candy
authors.affiliation: New England College of Optometry, Boston, Massachusetts.
authors.forename: Bruce
authors.initials: B
authors.lastname: Moore
authors.affiliation: University of Pennsylvania, Center for Preventive Ophthalmology & Biostatistics, Philadelphia, Pennsylvania.
authors.forename: Gui-Shuang
authors.initials: GS
authors.lastname: Ying
authors.affiliation: Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Graham
authors.initials: G
authors.lastname: Quinn
authors.affiliation: Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania.
authors.forename: Gale
authors.initials: G
authors.lastname: Orlansky
authors.affiliation: Northeastern State University College of Optometry, Tahlequah, Oklahoma.
authors.forename: Lynn
authors.initials: L
authors.lastname: Cyert
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D058453:Emmetropia / Q000502:physiology*; D005260:Female; D006801:Humans; D006956:Hyperopia / Q000503:physiopathology*; D008297:Male; D015348:Vision, Binocular / Q000502:physiology*; D014792:Visual Acuity / Q000502:physiology*