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D. Luisa Mayer, PhD; Ronald M. Hansen, PhD; Bruce D. Moore, OD; Suejin Kim, BS; Anne B. Fulton, MD

Arch Ophthalmol. 2001;119:1625-1628.

Objectives  To provide a description of refractive errors in healthy, term-born children, aged 1 through 48 months, and to test the hypotheses that spherical equivalent becomes significantly less hyperopic and less variable with increasing age.

Methods  Following a prospective, cross-sectional design, cycloplegic retinoscopy was used to measure the refractive error in both eyes of 514 healthy, term-born children in 12 age groups. Three hundred were aged 12 months or younger. Spherical equivalent and cylindrical power and axis were analyzed as a function of age. Prediction limits for spherical equivalent were calculated.

Results  Spherical equivalents of right and left eyes did not differ at any age. Hyperopia declined significantly with increasing age. The variability in spherical equivalent also decreased significantly with age. Cylindrical error of 1 diopter or more was found in 25% of the children; the proportion with astigmatism was highest in infancy and then waned. Myopia and anisometropia were rare, occurring in 3% and 1% of the sample, respectively.

Conclusions  Significant declines in hyperopia and variability of spherical equivalent appear to be features of emmetropization. The normal prediction limits provide guidelines against which data from individual patients can be compared.

From the Department of Ophthalmology, Children's Hospital Boston and Harvard Medical School (Drs Mayer, Hansen, and Fulton and Ms Kim), and the New England College of Optometry (Dr Moore), Boston, Mass.

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