SIGNIFICANCE
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.
PURPOSE
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.
METHODS
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.
RESULTS
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