Correction of Low-moderate Hyperopia Improves Accommodative Function for Some Hyperopic Children During Sustained Near Work

Purpose:This study investigated whether refractive correction improved accommodative function of hyperopic children while engaged in two sustained near activities.Methods:Sustained accommodative function of 63 participants (aged 5-10 years) with varying levels of uncorrected hyperopia (>/=+1.00D and <+5.00D spherical equivalent in least hyperopic eye) was measured using eccentric infrared photorefraction (PowerRef 3™, PlusOptix, Germany). Binocular accommodation measures were recorded while participants engaged in two tasks at 25cm for 15 minutes each: an ‘active’ task (reading small print on an Amazon Kindle), and a ‘passive’ task (watching animated movie on LCD screen). Participants also underwent a comprehensive visual assessment including measurement of presenting visual acuity, prism cover test and stereoacuity. Reading speed was assessed with and without hyperopic correction. Refractive error was determined by cycloplegic retinoscopy.Results: Hyperopic refractive correction significantly improved accuracy of accommodative responses in both task (pairwise comparisons: t=-3.70, P=0.001, and t=-4.93, P< 0.001 for reading and movie tasks respectively). Accommodative microfluctuations increased with refractive correction in the reading task (F (1,61) =25.77, P<0.001) but decreased in the movie task (F (1,59) =4.44, P=0.04). Reading speed also significantly increased with refractive correction (F (1,48) = 66.32, P<0.001). Conclusion:Correcting low-moderate levels of hyperopia has a positive impact on accommodative performance during sustained near activity in some schoolchildren. For these children, prescribing hyperopic correction may benefit performance in near vision tasks.