Effect of spectacles on changes of spherical hypermetropia in infants who did, and did not, have strabismus

doi:10.1136/bjo.84.3.324

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Scientific correspondence

Effect of spectacles on changes of spherical hypermetropia in infants who did, and did not, have strabismus R M Ingram^a, L E Gill^b, T W Lambert^b

^a Kettering General Hospital, ^b Institute of Health Sciences, Oxford

Correspondence to: Dr R M Ingram, 118 Northampton Road, Kettering, Northants, NN15 7LA

Accepted for publication 25 October 1999

AIM $---$ To explore why emmetropisation fails in children who havestrabismus.
METHODS $---$ 289 hypermetropic infants were randomly allocated spectacles and followed. Changes in spherical hypermetropia were comparedin those who had strabismus and those who did not. The effectof wearing glasses on these changes was assessed using t testsand regressionanalysis.
RESULTS $---$ Mean spherical hypermetropia decreased in both eyes of "normal" children (p<0.001). The consistent wearing of glasses impededthis process in both eyes (p<0.007). In the children with strabismus,there were no significant changes in either eye, irrespectiveof treatment (p>0.05).
CONCLUSIONS $---$ In contrast with normal infants, neither eye of those who had strabismus emmetropised, irrespective of whether the incomingvision was clear or blurred. It is suggested that these eyes didnot "recognise" the signal of blurred vision, and that they remainedlong sighted because they were destined to squint. Hence, thechildren did not squint because they were long sighted, and glassesdid not prevent themsquinting.

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