The Ohio State University College of Optometry, Columbus, Ohio.
Optom Vis Sci. 2023 May 1;100(5):304-311. doi: 10.1097/OPX.0000000000002011. Epub 2023 Mar 23.
Highly hyperopic children are at greater risk for developing conditions such as strabismus, amblyopia, and early literacy and reading problems. High hyperopia is a common finding in infants in a pediatric medical practice, and early detection can be done effectively in that setting with tropicamide autorefraction.
This study aimed to evaluate the effectiveness of a pilot screening program to detect high hyperopia in 2-month-old infants in a pediatric medical practice in Columbus, Ohio.
Cycloplegic refractive error (1% tropicamide) was measured by retinoscopy and autorefraction with the Welch Allyn SureSight (Welch Allyn/Hillrom, Skaneateles Falls, NY) in 473 infants (55.4% female) who were undergoing their 2-month well-baby visit at their pediatrician's medical practice. Cycloplegic retinoscopy (1% cyclopentolate) was repeated at a subsequent visit in 35 infants with ≥+5.00 D hyperopia in the most hyperopic meridian during the screening.
Twenty-eight infants (5.9%) had high hyperopia (spherical equivalent, ≥+5.00 D), and 61 (12.9%) had high hyperopia (≥+5.00 D in at least one meridian of at least one eye) by retinoscopy with 1% tropicamide. The mean ± standard deviation spherical equivalent tropicamide cycloplegic refractive error measured with retinoscopy was +2.54 ± 1.54 D (range, -3.25 to +7.00 D) and with SureSight was +2.29 ± 1.64 D (range, -2.90 to +7.53 D). Retinoscopy done using 1% cyclopentolate was 0.44 ± 0.54 D more hyperopic in spherical equivalent than with 1% tropicamide ( P < .001).
High hyperopia was a common finding in 2-month-old infants in a pediatric medical setting that could be detected effectively by cycloplegic autorefraction using tropicamide. Greater cooperation between pediatric primary vision and medical care could lead to effective vision screenings designed to detect high hyperopia in infants.
高度远视的儿童更容易出现斜视、弱视和早期读写问题等情况。在儿科医疗实践中，高度远视在婴儿中很常见，在这种环境下可以通过托吡卡胺自动折射有效地进行早期检测。
本研究旨在评估俄亥俄州哥伦布市儿科医疗实践中一项针对 2 个月大婴儿的高远视试点筛查计划的有效性。
对 473 名（55.4%为女性）正在儿科医生医疗实践中接受 2 个月大婴儿常规健康检查的婴儿进行睫状肌麻痹屈光不正（1%托吡卡胺）的视网膜检影和自动折射检查（Welch Allyn SureSight，Welch Allyn/Hillrom，Skaneateles Falls，NY）。在筛查过程中，35 名在最远视子午线的至少一眼的至少一子午线的远视度≥+5.00 D 的婴儿，随后在后续就诊时用 1%环戊酯进行睫状肌麻痹视网膜检影复查。
28 名婴儿（5.9%）患有高度远视（等效球镜度≥+5.00 D），61 名婴儿（12.9%）患有高度远视（1%托吡卡胺时，至少一眼的至少一子午线的远视度≥+5.00 D）。视网膜检影用 1%托吡卡胺测量的平均±标准偏差等效球镜屈光度为+2.54±1.54 D（范围-3.25 至+7.00 D），用 SureSight 测量的为+2.29±1.64 D（范围-2.90 至+7.53 D）。1%环戊酯进行的视网膜检影在等效球镜屈光度上比 1%托吡卡胺高 0.44±0.54 D（P<0.001）。
在儿科医疗环境中，高度远视在 2 个月大的婴儿中很常见，可以通过托吡卡胺睫状肌麻痹自动折射有效地检测到。儿科初级视力保健和医疗保健之间的更多合作，可以实现旨在检测婴儿高度远视的有效视力筛查。
