Jonathan M Holmes1, Marjean T Kulp2, Trevano W Dean3, Donny W Suh4, Raymond T Kraker3, David K Wallace5, David B Petersen6, Susan A Cotter7, Earl R Crouch8, Ingryd J Lorenzana9, Benjamin H Ticho10, Lisa C Verderber11, Katherine K Weise12. 1. Mayo Clinic, Rochester, Minnesota, USA. Electronic address: pedig@jaeb.org. 2. College of Optometry, The Ohio State University, Columbus, Ohio, USA. 3. Jaeb Center for Health Research, Tampa, Florida, USA. 4. University of Nebraska Medical Center, Omaha, Nebraska, USA. 5. Indiana University, Indianapolis, Indiana, USA. 6. Rocky Mountain Eye Care Associates, Salt Lake City, Utah, USA. 7. Southern California College of Optometry at Marshall B. Ketchum University, Fullerton, California, USA. 8. Virginia Pediatric Eye Center, Norfolk, Virginia, USA. 9. Advanced Vision Center, Schaumburg, Illinois, USA. 10. Ticho Eye Associates, Chicago Ridge, Illinois, USA. 11. Pediatric Eye Associates, Wilmette, Illinois, USA. 12. University of Alabama School of Optometry, Birmingham, Alabama, USA.
Abstract
PURPOSE: To compare visual acuity (VA) and binocularity outcomes in moderately hyperopic children with normal VA and binocularity assigned to glasses versus observation. DESIGN: Prospective randomized clinical trial (RCT). METHODS:One hundred nineteen3- to 5-year-old children with hyperopia between +3.00D and +6.00D spherical equivalent were randomly assigned to glasses versus observation (with glasses prescribed if deteriorated for subnormal distance VA or near stereoacuity, or manifest strabismus). Follow-up occurred every 6 months. At 3 years, the treatment strategy was classified as "failed" if any of the following were met, both with and without correction: subnormal distance VA or stereoacuity; manifest strabismus; or strabismus surgery during follow-up. RESULTS: Of 84 (71%) children who completed the primary outcome examination, failure occurred in five (12%; 95% confidence interval [CI]: 4%-26%) of 41 assigned to glasses and four (9%; 95% CI: 3%-22%) of 43 assigned to observation (difference = 3%; 95% CI: -12%-18%; P = .72). Deterioration prior to 3 years (requiring glasses per protocol) occurred in 29% (95% CI: 19%-43%) assigned to glasses and 27% (95% CI: 17%-42%) assigned to observation. CONCLUSIONS: In an RCT comparing glasses to observation for moderately hyperopic 3- to 5-year-old children with normal VA and binocularity, failure for VA or binocularity was not common. With insufficient enrollment and retention, our study was unable to determine whether immediate glasses prescription reduces failure rate, but low failure rates suggest that immediate glasses prescription for these children may not be needed to prevent failure for VA and/or binocularity.
RCT Entities:
PURPOSE: To compare visual acuity (VA) and binocularity outcomes in moderately hyperopic children with normal VA and binocularity assigned to glasses versus observation. DESIGN: Prospective randomized clinical trial (RCT). METHODS: One hundred nineteen 3- to 5-year-old children with hyperopia between +3.00D and +6.00D spherical equivalent were randomly assigned to glasses versus observation (with glasses prescribed if deteriorated for subnormal distance VA or near stereoacuity, or manifest strabismus). Follow-up occurred every 6 months. At 3 years, the treatment strategy was classified as "failed" if any of the following were met, both with and without correction: subnormal distance VA or stereoacuity; manifest strabismus; or strabismus surgery during follow-up. RESULTS: Of 84 (71%) children who completed the primary outcome examination, failure occurred in five (12%; 95% confidence interval [CI]: 4%-26%) of 41 assigned to glasses and four (9%; 95% CI: 3%-22%) of 43 assigned to observation (difference = 3%; 95% CI: -12%-18%; P = .72). Deterioration prior to 3 years (requiring glasses per protocol) occurred in 29% (95% CI: 19%-43%) assigned to glasses and 27% (95% CI: 17%-42%) assigned to observation. CONCLUSIONS: In an RCT comparing glasses to observation for moderately hyperopic 3- to 5-year-old children with normal VA and binocularity, failure for VA or binocularity was not common. With insufficient enrollment and retention, our study was unable to determine whether immediate glasses prescription reduces failure rate, but low failure rates suggest that immediate glasses prescription for these children may not be needed to prevent failure for VA and/or binocularity.
Authors: J M Holmes; R W Beck; M X Repka; D A Leske; R T Kraker; R C Blair; P S Moke; E E Birch; R A Saunders; R W Hertle; G E Quinn; K A Simons; J M Miller Journal: Arch Ophthalmol Date: 2001-09
Authors: Roy S Chuck; Deborah S Jacobs; Jimmy K Lee; Natalie A Afshari; Susan Vitale; Tueng T Shen; Jeremy D Keenan Journal: Ophthalmology Date: 2017-11-04 Impact factor: 12.079
Authors: David K Wallace; Stephen P Christiansen; Derek T Sprunger; Michele Melia; Katherine A Lee; Christie L Morse; Michael X Repka Journal: Ophthalmology Date: 2017-11-04 Impact factor: 12.079
Authors: Eileen Birch; Cathy Williams; James Drover; Valeria Fu; Christina Cheng; Kate Northstone; Mary Courage; Russell Adams Journal: J AAPOS Date: 2007-08-27 Impact factor: 1.220