Different corrections of hypermetropic errors in the successful treatment of hypermetropic amblyopia in children 3 to 7 years of age.

PURPOSE: To evaluate the improvement in visual acuity (VA) in children 3 to 7 years old with hypermetropic amblyopia after full or partial hypermetropic correction.

DESIGN: Retrospective interventional case series.

METHODS: Medical records of 182 children with hypermetropic amblyopia treated with partial or full hypermetropic correction from January 1, 2001 to July 31, 2007 were evaluated. Improvement in the VA of the amblyopic eye, changes in the power of glasses, and the reduction in hypermetropia were assessed.

RESULTS: Ninety-three children underwent full hypermetropic correction and the mean VA of their amblyopic eyes improved by 0.46 logarithm of minimal angle of resolution (logMAR). Eighty-one children underwent partial hypermetropic correction and the mean VA of their amblyopic eyes improved by 0.48 logMAR. The reduction in hypermetropia was 0.44 diopters (D)/year and 0.43 D/year, respectively. Changes in glasses at four to eight weeks of follow-up were noted in 11 children receiving full correction, all of whom were older than 5 years. Ten children, aged 3 to 5 years, with hypermetropia of more than 3 D and receiving partial correction, required a change of glasses and most (seven children) had underdiagnosed accommodative esotropia.

CONCLUSIONS: Both full correction and partial correction of hypermetropic errors improved the VA of 3 to 7-year-old children with hypermetropic amblyopia. The reduction in hypermetropia was similar after full and partial hypermetropic correction. However, for children older than 5 years, full correction should be undertaken with care because the accompanying blur at distance can hinder compliance. For younger children, especially with a high degree of hypermetropia, full correction might be required to avoid strabismus, which would cancel the effects of spectacle correction.