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PubMed2001

[Keratitis due to caterpillar of Pseudosphinx tetrio hairs].

A case of keratitis due to caterpillar hairs of the Pseudosphinx tetrio is reported. As he was clearing his garden without glasses or a protective headgear, the patient felt left ocular pain due to the projection of a caterpillar into the eye. On examination, there were numerous intrastromal caterpillar hairs involving the inferior temporal quadrant of the cornea. The small size of the hairs prevented removal with forceps. The patient was treated by extensive washing of the eyeball and topical application of anti-inflammatory drugs, cycloplegics and antibiotics. The caterpillar hairs gradually came off the cornea over a two-weeks period. The cornea remained free of any scar. Besides keratitis and conjunctivitis, caterpillar hairs are known to cause iris nodules, chronic uveitis, cataract, hyalitis, chorioretinitis, and orbital cellulitis.

Adult↗
PubMed2002

Nearwork in early-onset myopia.

PURPOSE: To determine the relationship of nearwork and myopia in young elementary school-age children in Singapore. METHODS: A cross-sectional study of 1005 school children aged 7 to 9 years was conducted in two schools in Singapore. Cycloplegic autorefraction, keratometry, and biometry measurements were performed. In addition, the parents completed a detailed questionnaire on nearwork activity (books read per week, reading in hours per day and diopter hours [addition of three times reading, two times computer use, and two times video games use in hours per day]). Other risk factors, such as parental myopia, socioeconomic status, and light exposure history, were assessed. RESULTS: In addition to socioeconomic factors, several nearwork indices were associated with myopia in these young children. The multivariate adjusted odds ratio of higher myopia (at least -3.0 D) for children who read more than two books per week was 3.05 (95% confidence interval [CI], 1.80-5.18). However, the odds ratios of higher myopia for children who read more than 2 hours per day or with more than 8 diopter hours (1.50; 95% CI, 0.87-2.55 and 1.04; 95% CI, 0.61-1.78, respectively) were not significant, after controlling for several factors. CONCLUSIONS: Children aged 7 to 9 years with a greater current reading exposure were more likely to be myopic. This association of reading and myopia in a young age cohort was greater than the strength of the reading association generally found in older myopic subjects. Whether these results identify an association of early-onset myopia with nearwork activity or other potentially confounding factors is discussed.

Age Distribution↗
PubMed1998

[Laser in situ keratomileusis for correction of myopia].

OBJECTIVE: To evaluate the efficacy and safety of laser in situ keratomileusis (LASIK) for the correction of myopia. METHODS: A total of 429 eyes with preoperative refraction of -2.00 to -28.00 diopters were treated with LASIK and followed up for more than 12 months. Based on the refraction, the patients were divided into 3 groups: Group I, -2.00, to -8.00 diopters, 179 eyes; Groups II, -8.25 to -15.00 diopters, 137 eyes; Group III, -15.25 to -28.00 diopters, 113 eyes. The examinations included cycloplegic refractions, Goldman tonometry, corneal sensitivity, contrast sensitivity, specular microscopy, pachymetry and corneal topography. The parameters of LASIK were: the thickness of corneal cap was 130 or 160 microns, and the maximum diameter of ablation zone was 6.8 mm. After surgery, fluorometholone was given to the patients topically for 1 or 2 months. RESULTS: The vision and refractions tended to be normal 3 months after operation. The contrast sensitivity returned to normal 3 to 6 months after surgery. The endothelium did not show any changes. At 12 months, respectively 88.8%, 79.6% and 70.8% in the above groups were within +/- 1D, 73.7%, 65.0% and 46.0% were within +/- 0.5D; the uncorrected visual acuity was 0.5 or better in 96.6%, 81.8% and 54.9% of the patients, 84.4%, 58.4% and 15.0% had vision of 1.0 or better. CONCLUSIONS: LASIK is effective and safe for the correction of mild, moderate and high myopia. However, it is more complicated than PRK and more dependent on the surgical skills.

Corneal Topography↗
PubMed2002

[Full optical correction after cycloplegia in headache].

PURPOSE: To study the advantages of cycloplegia in the accurate assessment of refractive errors and to evaluate the impact of full optical correction in the course of headache. MATERIAL: and methods: A prospective study was carried out in 164 eyes of 82 patients with headache. Corrected visual acuity was 10/10 in all cases. Refraction was measured before and under cycloplegia by cyclopentolate with a CANON R 50 infrared autorefractometer. Full optical cycloplegic correction based on the value of refraction under cycloplegia was prescribed in all cases. Mean follow-up was 10 months. Statistical analyses were used: Student's t test, Pearson coefficient correlation, and Chi2. RESULTS: Under cycloplegia, hypermetropia was significantly the most frequent ametropia (67.1%, p<10(- 9)). The difference between the spherical equivalent, before and during cycloplegia, was highly significant (p<10(- 5)) at 0.79. Optical correction eliminated headaches in 76.5% of the cases. CONCLUSION: The authors conclude on the role of accommodation in headache onset and the need to continue cycloplegia until the age of 45. The importance of optical correction in alleviating headaches is underlined.

Accommodation, Ocular↗
PubMed2002

Mechanisms of myopia in Cohen syndrome mapped to chromosome 8q22.

PURPOSE: To analyze the mechanisms of myopia in Cohen syndrome (Mendelian Inheritance in Man [MIM] no. 216550). METHODS: A cross-sectional study of 22 Finnish patients (age range, 2-57 years) with Cohen syndrome, which maps to chromosome 8q22, was undertaken to record cycloplegic refraction, keratometry (corneal power and radius of curvature), biometry (anterior chamber depth [ACD], lens thickness [LT], axial [AL] and vitreal length [VL]), and Hoffer Q-modeled lens power. These components of refraction were correlated to age and spherical equivalent (SE) at the corneal plane. Contribution to total myopia of refractive (corneal and lenticular) and axial components was modeled by multiple linear regression and by estimating the effect of deviation from population mean values. RESULTS: The mean SE in patients with Cohen syndrome older than 10 years was -9.35 D; the mean cylinder power, +1.70 D; and the mean anisometropia, 0.53 D. Relative to the emmetropic eye of a young adult, the AL and VL (mean, 23.9 and 16.6 mm, respectively) and lens power (mean, 30.30 D) were higher in 74% and 93% of patients, respectively, and the ACD (mean, 2.5 mm) was smaller and the LT (mean, 4.9 mm) and corneal power (mean, 45.63 D) higher than average in all patients. Corneal power (r = 0.513, P = 0.021) increased with age, but AL and VL (P = 0.46 and 0.54, respectively) and lens power (P = 0.89) did not correlate with age. The lens power decreased with AL (r = -0.564, P = 0.029) and tended to increase with corneal power (r = 0.475, P = 0.074). Multiple linear regression identified AL and corneal power as independent predictors of SE. Based on deviation from population means, the lens power explained 55%, corneal power 23%, and AL 22% of total myopia. ACD decreased and LT increased markedly with age, rendering angle-closure glaucoma a possibility. CONCLUSIONS: Myopia in Cohen syndrome is mainly refractive in type and is due to high corneal and lenticular power, which is otherwise rare in young patients. It may be superimposed on axial myopia, probably related to polygenic factors that determine myopia in the general population. The refractive myopia in Cohen syndrome may result from dysgenesis and atrophy of the cornea, ciliary body, and iris, which in turn cause iridial and zonular laxity and spherophakia.

Abnormalities, Multiple↗
PubMed2002

[Corneal asphericity in myopes].

PURPOSE: To study the variations of corneal asphericity in a population of myopic patients. METHODS: One hundred consecutive myopic patients were included in this study. The EyeSys videokeratoscope was used to assess the corneal topography of these patients seeking refractive surgery. We compared the results of cycloplegic refractions with the values of the corneal asphericity and mean central keratometry. RESULTS: Mean corneal asphericity was -0.09. Eighty per cent of the myopic patients had a prolate corneal contour, whereas 20% had an oblate corneal contour. No significant relationship was found between the corneal asphericity value and the mean keratometry value or the mean refractive error. CONCLUSION: The mean corneal asphericity in our myopic population was -0.09. This is slightly more than previously reported data in similar studies. No statistically significant relationship was found between corneal asphericity, mean refractive error, and mean keratometry.

Adult↗
PubMed2002

Excessive myopia and anisometropia associated with familial exudative vitreoretinopathy.

BACKGROUND: To describe associations between familial exudative vitreoretinopathy (FEVR) and refractive status. METHODS: We conducted retrospective studies of patients with clinical diagnoses of familial exudative vitreoretinopathy from June 1986 through September 2000. All patients had cycloplegic refraction, visual acuity with correction, and underwent fundus examination. Ocular history since early childhood was described. RESULTS: Nine patients were recruited. All had excessive myopia, which was noted since early childhood. Amblyopia was noted in seven of the nine patients. Asymmetric FEVR was found in four of the nine patients. In all four patients with asymmetric FEVR, anisometropia equal to or greater than 2.5D was noted. Myopia was higher and amblyopia was more severe in the eye more severely affected with FEVR. CONCLUSION: Excessive myopia, anisometropia and amblyopia were more likely to occur in eyes with familial exudative vitreoretinopathy. Patients with asymmetric disease tended to have higher myopia in the eye with more severe degree of FEVR as compared with the paired eye and thus correlated with anisometropia.

Adolescent↗
PubMed2002

[Bilateral acute angle closure glaucoma following topiramate treatment].

We describe a case of bilateral acute angle closure glaucoma associated with oral topiramate therapy. A 64 year old woman developed bilateral acute angle closure glaucoma two weeks after beginning topiramate therapy for peripheral diabetic neuropathy. A topical and systemic anti-glaucomatous treatment were given and laser peripheral iridotomies were performed and, the intraocular pressure were stabilized. However, the anterior chambers remained very shallow and peripheral ciliochoroidal detachment was observed and confirmed echographically. Assuming that the mechanism of acute bilateral simultaneous angle closure glaucoma differs from the common pupillary block, and is related to external cause, the topiramate therapy was discontinued, and the patient was treated with cycloplegic agent and steroids. A gradual deepening of the anterior chamber and resolution of the choroidal edema were accompanied by improvement of visual acuity and corneal clarity. The presumed mechanism of drug related acute bilateral angle closure glaucoma is choroidal effusion and detachment associated with forward budging of the iris-lens diaphragm. This, in turn, causes a shallow anterior chamber and blockage of the ocular draining system.

Cornea↗
PubMed2002

The Hong Kong progressive lens myopia control study: study design and main findings.

PURPOSE: To determine whether the use of progressive addition spectacle lenses reduced the progression of myopia, over a 2-year period, in Hong Kong children between the ages of 7 and 10.5 years. METHODS: A clinical trial was carried out to compare the progression in myopia in a treatment group of 138 (121 retained) subjects wearing progressive lenses (PAL; add +1.50 D) and in a control group of 160 (133 retained) subjects wearing single vision lenses (SV). The research design was masked with random allocation to groups. Primary measurements outcomes were spherical equivalent refractive error and axial length (both measured using a cycloplegic agent). RESULTS: There were no statistically significant differences between the PAL and the SV groups for of any of the baseline outcome measures. After 2 years there had been statistically significant increases in myopia and axial length in both groups; however, there was no difference in the increases that occurred between the two groups. CONCLUSIONS: The research design used resulted in matched treatment and control groups. There was no evidence that progression of myopia was retarded by wearing progressive addition lenses, either in terms of refractive error or axial length.

Child↗
PubMed2002

[Epidemiologic study of refractive errors in schoolchildren in socioeconomically deprived regions in Tunisia].

PURPOSE: This study's purpose was to estimate the prevalence of common refractive errors in schoolchildren in low socioeconomic regions in Tunisia and to assess their effect on school performance. MATERIAL AND METHODS: This was a cross-sectional study done from November 1999 to January 2000 within the context of health care screening campaigns carried out by volunteer ophthalmologists and opticians in low-end socioeconomic regions in Tunisia. The concerned population was schoolchildren living in the cities of Tunis and Tabarka (North), Kerkena (Center), and Tozeur (South). We examined a total of 708 children with a mean age of 11.9 +/-3.21 years (from 6 to 20 years) and a sex ratio of 0.84. A cycloplegic refraction examination was performed on all the children. Statistical analyses with the chi squared test and the Fisher exact test allowed us to calculate the prevalence of the refractive errors totally and separately as well as the distribution according to age, sex, and region. We also searched for a possible relation between refractive errors and academic failure. RESULTS: Among the 708 children, 57.2% [CI(95)=53.4-60] had refractive errors, of which 31.6% [CI(95)=28.2-35.2] were hyperopic, whereas 9.1% [CI(95)=7.1-11.5] were myopic. Astigmatism was found in 16.4% [CI(95)=13.7-19.3]. The prevalence of myopia was significantly higher after the age of fourteen. It increased significantly with age (P=0.0003). The prevalence of hyperopia was significantly higher between the ages of 8 and 11 (P=0.0004). Hyperopic astigmatism was significantly more frequent between 6 and 9 years of age (P=0.001). There was no significant difference regarding sex. However, the distribution of the refractive errors by region showed a significantly high level of myopia in Tunis, Kerkena, and Tozeur. This difference disappeared with increasing age. The study of the effect of these refractive errors on school performance of these children from poor areas showed a significant association between all types of refractive errors and academic failure, with an odds ratio of 2.13 for all types of refractive errors, 2.69 for hyperopia, 2.87 for myopia, and 2.73 for astigmatism. CONCLUSION: This study showed the prevalence of refractive errors in a poor population of schoolchildren and emphasized the importance of such examinations. The ability of a child to participate in the educational experience is at least partially dependent on good vision.

Adolescent↗
PubMed2002

[Incidence of vitreoretinal pathologic conditions in myopic eyes after laser in situ keratomileusis].

OBJECTIVE: To determine the incidence of vitreoretinal pathologic conditions in myopic eyes after laser in situ keratomileusis. METHODS: Vitreoretinal pathologic conditions of 1981 consecutive eyes (995 patients) having undergone laser-assisted in situ keratomileusis for the correction of myopia were studied. Preoperative and postoperative basic examinations included visual acuity, manifest and cycloplegic refraction, slit-lamp microscope examination, applanation tonometry and a fundus examination after pupil dilatation by indirect ophthalmoscopy and biomicroscopy with spherical lens of + 90 diopters. Before laser in situ keratomileusis, preventive treatment was carried out for predisposing lesion of retinal detachment in 8 eyes: 6 eyes for lattice degeneration and 2 eyes for atrophic holes. Postoperative examinations were conducted at 1, 3 and 12 months and once a year thereafter. All eyes were followed up for >/= 12 months. RESULTS: Eyes were followed for a mean of (18.40 +/- 4.50) months (range 12 - 28) after the surgery. Sixteen eyes of 13 patients (0.81%) developed vitreoretinopathy after LASIK, including 6 eyes with lattice degeneration (0.30%) in which one of them had previous laser treatment, 2 with posterior vitreous detachment (0.10%), 2 with macular hemorrhage (0.10%), 4 with rhegmatogenous retinal detachment (0.20%), and 2 with retinal tear without retinal detachment (0.10%) in which one of them had previous laser treatment for lattice degeneration. Five patients were males (5 eyes involved). Others were females. Mean age of the group with vitreoretinal pathologic conditions was 31.80 +/- 5.85 years (range 22 to 43). The interval between refractive surgery and development of vitreoretinal complication was (10.38 +/- 6.20) months (range 1 to 24). The eyes that developed vitreoretinopathy had myopia -4.75 to -15.00 diopters (mean -9.45 +/- 2.61 D) before LASIK. The comparison of incidences of vitreoretinopathy after LASIK between the group of >/= -6.00 D and < -6.00 D before surgery showed significant difference (P < 0.01, chi(2) = 60.78). The comparison of incidences of vitreoretinopathy after LASIK had also significant difference (P < 0.01, chi(2) = 138.64) between the eyes with pre-LASIK lattice degeneration and dry hole and eyes without such lesions. The cases of lattice degeneration and retinal tear were treated with laser retinopexy. All cases of rhegmatogenous retinal detachment were managed with cryoretinopexy and scleral buckling. Retinal reattachment was attained in all eyes and good visual acuities were recovered. CONCLUSION: No direct cause-effect relationship between LASIK and vitreoretinopathy can be proven from this study. Although the incidence of vitreoretinal pathologic conditions in myopic eyes after laser in situ keratomileusis is low, it is necessary to strictly filter candidates. Preoperatively and postoperatively, pay attention to the lattice degeneration and other retina lesions, and long-term follow-up is important.

Adolescent↗
PubMed2003

Tubulointerstitial nephritis and uveitis syndrome.

BACKGROUND: Uveitis in association with tubulointerstitial nephritis is a distinct clinical entity known as tubulointerstitial nephritis and uveitis(TINU) syndrome. The onset of uveitis most commonly follows the onset of the interstitial nephritis, but may also occur before or concurrently. The uveitis is usually bilateral, nongranulomatous, limited to the anterior segment, and generally responds well to topical or oral (when indicated) anti-inflammatory treatment. Interestingly, recurrent or chronic uveitis is common, in contrast to the tubulointerstitial nephritis, which typically resolves completely. CASE REPORT: Approximately 5 months after a biopsy confirmed the diagnosis of tubulointerstitial nephritis, a 13-year-old boy was brought to our clinic with symptoms of a red, photophobic right eye of 3 days duration. Examination revealed nongranulomatous anterior-segment inflammation in the right eye greater than the left. The uveitis responded very well to topical steroid and cycloplegic treatment. Follow-up examinations have shown a gradual decrease in the inflammation, with no ocular complications. CONCLUSION: TINU syndrome is an under-recognized disorder and may account for some cases of uveitis otherwise characterized as 'idiopathic." Since the uveitis may be the presenting sign in up to 36% of cases of TINU syndrome, it is important for eye care practitioners to consider this disorder when searching for systemic associations with uveitis. Prompt detection through referral or testing will allow speedy diagnosis and appropriate treatment for both the uveitis and the tubulointerstitial nephritis.

Adolescent↗
PubMed2003

[Bilateral uveitis with definitive hypotony caused by systemic cidofovir].

We report the case of a 52-year-old man with AIDS and CMV bilateral retinitis, treated first with ganciclovir (cymevan) and then with cidofovir. During the treatment, the patient complained of a sharp decrease in visual acuity. Cycloplegics and topical corticosteroids were given. Then cidofovir was stopped and replaced with intravenous Foscavir because of the clinical inefficacy. The anterior uveitis resolved but the ciliary secretion has not stopped after 12 months of follow-up. The patient presented +11 hypermetropia with a choroidal edema and bilateral cataract. This case is interesting for its permanent hypotony and bilateral uveitis. A literature search has brought out a rate of only 3% of chronic hypotony. We hypothesize bilateral iatrogenic ciliary body necrosis, as described in the animal models.

AIDS-Related Opportunistic Infections↗
PubMed1992

[The effect of horizontal strabismus surgery on the refractive status in children].

The refractive changes in 84 children (155 eyes) following horizontal strabismus surgery and in 97 children (181 eyes) without surgical intervention were studied. The results indicated that the spherical refraction and axis of astigmatism were not significantly affected by the operation, especially when both recession and resection were done on the same eye; however, the cylindrical refraction changed markedly within 6 weeks of surgery. These changes would be minimized and become stable 6 weeks after the operation, suggesting that the proper time for a cycloplegic refraction was 6 weeks after a horizontal strabismus surgery.

Adolescent↗
PubMed2003

[Study of refractive changes inTimiş.county].

The aim of the study was to assess the prevalence of common refractive errors în children investigated at the "Louis Turcanu" Hospital's Ambulatory from Timisoara. This was a cross-sectional study done from January to June 2002 în the Ophthalmologic Medical Office. The target group was those of children from Timis County. We examined 646 children with a mean age of 10.7 years (from 0 to 18 years). A cycloplegic refraction examination was performed on all the children, using a computerized Humphrey-Zeiss autorefractometer. The statistical analysis was performed using CDC's Epi Info 2002. în the analysis, we used the Odds Ratio, the exact Fisher test and the chi-squared test. Among the 646 children, 407--63% (CI95 = 59.1-66.7) had refraction errors, of which 1.5% (CI95 = 0.8-2.9) were myopic whereas 49.8% (CI95 = 45.9-53.8) were hyperopic. Astigmatism was found în 11.8% (CI95 = 9.4-14.6). The study showed higher prevalence for the 14-16 age, emphasizing the importance of these examinations.

Adolescent↗
PubMed2004

Prevalence of myopia in Taiwanese schoolchildren: 1983 to 2000.

INTRODUCTION: To determine time trends in myopia over a 20-year period in Taiwan, we conducted 5 nationwide surveys pertaining to the ocular refraction of schoolchildren in 1983, 1986, 1990, 1995 and 2000. MATERIALS AND METHODS: The sampling technique used herein involved the assessment of stratified systematic clusters, with the unweighted myopic rate being represented using data derived from different sectors of the population, such as metropolitan, city, town, and aboriginal. The mean values for the spherical equivalent of the cycloplegic refractive status and the dimension of corneal radii as determined by the autorefractometer were used for the calculation. RESULTS: In our review of 5 nationwide myopia surveys, we found that the mean prevalence of myopia among 7 year olds increased from 5.8% in 1983 to 21% in 2000. At the age of 12, the prevalence of myopia was 36.7% in 1983 increasing to 61% in 2000, corresponding figures for 15-year-olds being 64.2% and 81%, respectively. The prevalence of myopia increased from 74% in 1983 to 84% in 2000 for children aged between 16 and 18 years, and, in addition, the prevalence of high myopia (over -6.0 D) increased from 10.9% in 1983 to 21% of 18-year-old students of Taiwan in 2000. The mean refractive status at the age of 12 deteriorated from -0.48 D in 1983 to -1.45 D in 2000, and from -1.49 D to -2.89 D for children aged 15, whilst for individuals aged 18, it deteriorated from -2.55 D in 1983 to -3.64 D in 2000. The mean ocular refraction began to progress to a myopic condition at the age of 11 in 1983, this becoming an age of 8 years in 2000. There appeared to be significant difference in both the prevalence and the degree of myopia between study participants residing in cities and villages. CONCLUSIONS: We conclude that the cause of the relative increasing severity of myopia among the schoolchildren was due to the onset of myopia at a very young, and progressively-decreasing, age over the study period. Thus, to reduce the prevalence and severity of myopia, we should pay more attention to the eye care of pre-schoolchildren.

Adolescent↗
PubMed2003

[Ocular changes in hemorrhagic fever with renal syndrome].

Hemorrhagic fever with renal syndrome (HFRS) is a rodent-originating zoonotic disease caused by Puumala and Dobrava viruses, which belong to the genus Hantavirus. The most prominent ocular change in HFRS is transient myopia, which lasts for up to one week and is due to a forward movement of the ocular anterior diaphragm and thickening of the lens. Other ophthalmic manifestations of HFRS are eyelid edema, conjunctival injection with or without hemorrhages, chemosis, anterior uveitis, retinal edema with or without hemorrhages, and photophobia. Acute glaucoma attacks, which are rare, could be explained by the increased intraocular pressure (IOP) due to edema and hemorrhage in the ciliary body, causing anterolateral rotation, relaxation of the zonules, and anterior movement of the lens. They are treated with mydriatic-cycloplegic and corticosteroid eye drops and with furosemide. However, there are also controversial reports on decreased IOP during the acute phase of HFRS. Despite the fact that ocular symptoms in HFRS are common generally they do not require any medical therapy and the recovery of the patients is complete.

Eye Diseases↗
PubMed2004

Pseudo-false positive eye/vision photoscreening due to accommodative insufficiency. A serendipitous benefit for poor readers?

BACKGROUND: Children whose eyes and vision are otherwise normal and who should screen negatively as normals, but who fail to compensate for their normal mild hyperopia (i.e. by normally accommodating, or rather actually failing to accommodate) will generate hyperopic crescents in a photoscreen test that can be interpreted as "positive" (for pathology) because high and asymmetric levels of hyperopia are common risk factors for amblyopia. This would therefore usually be considered a "false positive" and no further care would be offered. However, this failure to compensate, may in fact be a pathological disorder, accommodative insufficiency, making this apparently "false positive" situation actually a actually a "false-positive-false- negative positive test", or more simply a "false- false positive test". METHODS: The Alaska Blind Child Discovery Project photoscreened just under 16,000 children referring 6% as "positive", of which, after examination, the false positive rate was just 6% of those referred (0.4% of the total number screened). RESULTS: Ten (42%) of the 24 false positives had evidence of accommodative insufficiency inspite of only average (for age) amounts of cycloplegic hyperopia and a lag of accommodation on dynamic retinoscopy. Eight of the 10 were boys of kindergarten age. Most of these subsequently benefitted from prescription and use of reading glasses of low plus sphere correction. CONCLUSION: About 0.15% of photoscreened children, or 2.5% of those screening positive, and 42% (10/24) found initially on exam to be falsely positive, yielding hyperopic interpretations despite low and usually acceptably normal for age amounts of hyperopia, are in fact suffering from a pathological accommodative insufficiency. Identification of such false- false positives by a combination of photoscreening and dynamic retinoscopy may be used to determine which students might be helped with enforced reading glasses. Confirmatory exams on photoscreen positive-hyperopia cases should include an assessment of accommodation to identify these children.

Accommodation, Ocular↗