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Hypo-accommodation responses in hypermetropic infants and children

Horwood, A. M. ORCID: and Riddell, P. M. ORCID: (2011) Hypo-accommodation responses in hypermetropic infants and children. British Journal of Ophthalmology, 97 (2). pp. 231-237. ISSN 0007-1161

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To link to this item DOI: 10.1136/bjo.2009.177378


Aims: Accommodation to overcome hypermetropia is implicated in emmetropisation. This study recorded accommodation responses in a wide range of emmetropising infants and older children with clinically significant hypermetropia to assess common characteristics and differences. Methods: A PlusoptiXSO4 photorefractor in a laboratory setting was used to collect binocular accommodation data from participants viewing a detailed picture target moving between 33cm and 2m. 38 typically developing infants were studied between 6-26 weeks of age and were compared with cross-sectional data from children 5-9 years of age with clinically significant hypermetropia (n=15), corrected fully accommodative strabismus (n=14) and 27 age-matched controls. Results: Hypermetropes of all ages under-accommodated compared to controls at all distances, whether corrected or not (p<0.00001) and lag related to manifest refraction. Emmetropising infants under-accommodated most in the distance, while the hypermetropic patient groups underaccommodated most for near. Conclusions: Better accommodation for near than distance is demonstrated in those hypermetropic children who go on to emmetropise. This supports the approach of avoiding refractive correction in such children. In contrast, hypermetropic children referred for treatment for reduced distance visual acuity are not likely to habitually accommodate to overcome residual hypermetropia left by an under-correction.

Item Type:Article
Divisions:Life Sciences > School of Psychology and Clinical Language Sciences > Development
Life Sciences > School of Psychology and Clinical Language Sciences > Department of Psychology
ID Code:7680
Uncontrolled Keywords:Hyperopia: Accommodation, ocular: Infant: Child: Emmetropisation
Publisher:BMJ Publishing Group
Publisher Statement:This article has been accepted for publication in British Journal of Ophthalmology (BJO). The definitive copyedited, typeset version Hypo-accommodation responses in hypermetropic infants and children Anna M Horwood, Patricia M Riddell, Br J Ophthalmol doi:10.1136/bjo.2009.177378 is available online at :


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