Prevalence of hyperopia and associations with eye findings in 6- and 12-year-olds.

PURPOSE: To describe the prevalence of hyperopia and associated factors in a representative sample of Australian schoolchildren 6 and 12 years old.
DESIGN: Population-based cross-sectional study. PARTICIPANTS: Schoolchildren ages 6 (n = 1765) and 12 (n = 2353) from 55 randomly selected schools across Sydney.
METHODS: Detailed eye examinations included cycloplegic autorefraction, ocular biometry, cover testing, and dilated fundus examination. Information on birth and medical history were obtained from a parent questionnaire. MAIN OUTCOME MEASURES: Moderate hyperopia defined as spherical equivalent (SE) refraction of > or =+2.00 diopters (D), and eye conditions including amblyopia, strabismus, astigmatism, and anisometropia.
RESULTS: Prevalences of moderate hyperopia among children ages 6 and 12 were 13.2% and 5.0%, respectively; it was more frequent in children of Caucasian ethnicity (15.7% and 6.8%, respectively) than in children of other ethnic groups. Compared with children without significant ametropia (-0.49 < or = SE refraction < or = +1.99 D), the prevalence of eye conditions including amblyopia, strabismus, abnormal convergence, and reduced stereoacuity was significantly greater in children with moderate hyperopia (all Ps < 0.01). Maternal smoking was significantly associated with moderate hyperopia among 6-year-olds (P = 0.03), but this association was borderline among 12-year-olds (P = 0.055). Early gestational age (<37 weeks) and low birth weight (<2500 g) were not statistically significant predictors of moderate hyperopia in childhood.
CONCLUSIONS: Moderate hyperopia was strongly associated with many common eye conditions, particularly amblyopia and strabismus, in older children. Birth parameters did not predict moderate hyperopia.