This article was reviewed by Donny Won Suh, MD
Results from the Hyperopia Treatment Study 1 (HTS1) have proven to be inconclusive after three years of follow-up in young children with moderate hyperopia treated with glasses compared with observation. A small-to-moderate benefit or no benefit of immediate glasses was seen compared with observation.
The study rationale was that 4% to 14% of children have moderate to high levels of hyperopia, a scenario that carries a significantly increased risk for development of strabismus and amblyopia. Based on previous studies, it is controversial whether glasses should be prescribed immediately for children with moderate myopia to prevent amblyopia and strabismus from developing.
The alternative is observation until signs of decompensation become apparent followed by prescribing of glasses, according to Donny Won Suh, MD, chief of pediatric ophthalmology, University of Nebraska Ophthalmology, Children’s Hospital and Medical Center, Omaha.
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Dr. Suh and Marjean Kulp, MD, were protocol chairpersons of the HTS1 that sought to determine the visual acuity (VA) and alignment benefits, if any, of immediate eyeglass prescription compared with observation for children from 1 to less than 3 years of age who had +3.0 to +6.0 D of hyperopia after a follow-up period of three years.
The 106 study patients with anisometropia and mild astigmatism and no apparent strabismus were randomly selected to either having eyeglasses prescribed immediately or observation and followed every six months for three years. During follow-up, if decompensation became apparent in the observation group, glasses and other appropriate treatments were prescribed.
Criteria included decreased distance VA, decreased stereoacuity, and heterotropia. During follow-up, investigators were alert to any signs of permanent damage.