The effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia

Longitudinal Changes in Refractive Development in Highly Hyperopic Children: A 2.6-11.2 Year Follow-up of Preschoolers Diagnosed with High Hyperopia

PURPOSE

This study aims to elucidate the longitudinal refractive and ocular biometric alterations in preschool children with high hyperopia who underwent early interventions.

METHODS

We conducted a retrospective analysis of preschool children diagnosed with high hyperopia at Tianjin Medical University Eye Hospital between 2011 and 2023. Inclusion criteria required an initial examination with cycloplegic refraction, bilateral spherical equivalent power (SE) ≥ +5.00D with a difference <1.00D, a minimum two-year follow-up, and at least three ocular biometric measurements. The annual axial growth rate evaluated emmetropization in highly hyperopic children. We applied Restricted Cubic Spline (RCS) models to explore potential nonlinear relationships between age and spherical equivalent, axial length, corneal curvature, and axial length-to-corneal curvature ratio. Additionally, Mixed-effects models were employed to investigate factors associated with changes in refractive error and axial length.

RESULTS

The study enrolled 60 eligible subjects, with a median initial diagnosis age of 3.5 years (IQR, 2.8-4.9 years) and a median last visit age of 9.3 years (IQR, 8.1-10.8 years). The average follow-up duration was 5.7 years. RCS analysis revealed notable nonlinear changes in spherical equivalent power, axial length, and axial length-to-corneal curvature ratio, although corneal curvature displayed no statistically significant nonlinear trend. Factors affecting SE changes included the presence of strabismus, the use of cycloplegia, baseline SE, and age. Conversely, changes in axial length solely correlated with baseline axial length and age.

CONCLUSION

Highly hyperopic preschool children undergoing early intervention display a marked emmetropization tendency, though most still remain moderately to highly hyperopic, with the progression of refractive changes showing non-uniform patterns with respect to age.

Measurements of oculo-palpebral landmarks and evaluation of patient's head position

PURPOSE

Keeping the head in a neutral position is requisite for glasses/lenses/head-up designs, the suitability of oculo-plastic surgery and for the grading the eye shift. Anatomically incompatible glasses are one of the common problems affecting accommodation, reducing comfort and disturbing by causing symptoms such as dizziness and nausea. The oculo-palpebral measurements act as a key determinant in symmetrical facial attractiveness. This study aims to investigate the most effective oculo-palpebral landmarks, head-neutral as the ideal position, taking into account of individual anatomical differences of these patients.

METHODS

100 females and 100 males aged between 18 and 20 years were photographed. Digital photogrammetric measurements were made with the ImageJ program. Interpupillary and interhelical distances, besides bilateral palpebral fissure length and height, and iris diameter were calculated on front-facing photographs.

RESULTS

Mean interpupillary distance was measured wider in males than in females. The mean length of palpebral fissure was 31 mm; palpebral fissure height was 10 mm. These figures were valid in both eyes and gender. The interhelical distance was calculated as the mean and was measured longer in men. Since the measurement values were the same in both sexes and on both sides, they were determined as important landmarks for controlling the head-neutral position, evaluating whether there was a deviation in the eye, and measuring the numerical value when detected.

CONCLUSION

It is essential to check the side-symmetry of the patient's palpebral fissure height, palpebral fissure length, diameter of iris and corneal depth during oculo-plastic invention and artificial design.