Management of childhood hyperopia: A pediatric optometrist's perspective

Purpose. To provide an optometric perspective on the management of hyperopia in children without strabismus or amblyopia. Methods. Factors that have potentially shaped optometry's viewpoint and influenced its prescribing philosophy for childhood hyperopia, such as optometry school and residency training, professional association clinical guidelines, conferences and continuing education courses, textbooks, scientific studies, opinions of professional leaders, and clinical experiences are discussed. Results. Variations in prescribing patterns for childhood hyperopia occur within optometry and within ophthalmology. There are also differences in prescribing philosophies between the two professions. These differences are probably due to a greater level of concern, more so among optometrists, about associated vision functions such as accommodation, vergence, and stereopsis, as well as concerns about the potential impact of uncorrected hyperopia on reading and school performance. Conclusions. If indications for prescribing spectacles for children with hyperopia are to be validated, randomized controlled trials need to be performed.