Last week we blogged about the importance of newly published research based on an NEI-NIH Funded Study that shifts the conversation away from uncorrected hyperopia in young children as being a risk factor solely for strabismus and amblyopia, and focusing a spotlight on the acquisition of literacy. I also mentioned being enamored with the acquisition of the Encyclopedia of the Eye, with its many tantalizing entries on a wide variety of topics not normally assembled between two covers (or eight, if you count the fact that there are four volumes!). One of the topics in the Encyclopedia is Hyperopia, and I expected to breeze through that without learning much new. After all the Encycolpedia came out five years ago, and what new was there to say about the subject?
Just goes to show you that literacy can take you to some places where you might have otherwise not gone. The entry on Hyperopia by Elise Harb, O.D., M.S. from NECO is very well done, and she repeatedly references the AOA Clinical Practice Guideline (CPG) on the topic, of which she is a co-author. Here a couple of powerful statements from that CPG:
“There is no universal approach to the treatment of hyperopia. Each patient should be considered in terms of age, degree of symptoms, amount of hyperopia, state of accommodation, visual acuity, and efficiency during the performance of visual tasks. The goals of treatment are to reduce accommodative demand and to provide clear, comfortable vision and normal binocularity. It is not simply determination of the lens power required to focus light onto the retina, but a complex approach encompassing the patient’s vision needs and sensitivity.”
“Young children (birth-10 years of age) with low to moderate hyperopia, but without strabismus, amblyopia, or other significant vision problems, usually require no treatment. However, even occasional evidence of decreased visual acuity, binocular anomalies, or functional vision problems may signal the need for treatment. Whereas the effects of uncorrected hyperopia may manifest as visual perceptual dysfunction reading difficulties, or failure in school, any child with hyperopia who is experiencing learning or other school difficulties needs careful assessment and may require treatment.”
Despite the fact that I have repeatedly championed the AOA CPGs on Amblyopia, Strabismus, Vergence, Pediatric Examination, and LRVPs, I had never really paid much attention to the one on Hyperopia. Consider that corrected, and keep in mind how valuable these CPGs are when referencing what is considered mainstream thinking about issues we deal with every day in clinical practice.