Treatment for Hypermetropia in Children
Prescribe convex lenses (plus lenses) to correct the hypermetropia. 1
Understanding the Optical Correction
Hypermetropia (farsightedness) requires convex (plus) lenses to converge light rays so they focus properly on the retina rather than behind it. 2, 3 This is fundamental optics—hyperopic eyes need positive power lenses to correct the refractive error.
Clinical Approach to Prescribing
For children with hypermetropia causing visual symptoms (like difficulty seeing the board), eyeglasses are generally prescribed for +1.00 D or more of hyperopia. 1 The American Academy of Ophthalmology 2023 guidelines emphasize that correction of significant refractive errors should be the initial treatment for children with visual complaints. 1
Key Prescribing Principles:
Full cycloplegic refraction should guide the prescription in most cases, particularly in younger children, to determine the true refractive error without accommodation interference. 1
In older children, a manifest (non-cycloplegic) refraction may be required to optimize visual acuity, as correction of the full cycloplegic refractive error may blur their distance vision. 1
Impact-resistant lenses are preferable for children and often mandated by state law for safety. 1
Important Clinical Considerations
Hypermetropia greater than +5.00 D carries significant risk for amblyopia and strabismus development, making optical correction essential. 4 Even moderate hypermetropia (+3.00 D or higher) can cause visual problems if left uncorrected, including difficulty with near tasks and potential amblyopia. 2, 3
Common Pitfalls to Avoid:
Do not undercorrect symptomatic hypermetropia thinking the child's accommodation will compensate—this risks continued visual impairment and poor academic performance. 5
Ensure proper fitting and adjustment of eyeglasses to facilitate acceptance; head straps or flexible frames may be useful in younger children. 1
Monitor compliance carefully, as poor eyeglass compliance leads to poor visual and sensorimotor outcomes. 1
Follow-Up Strategy
Improved visual acuity should be evident within several weeks of consistent wear. 5 If symptoms persist despite appropriate correction, repeat refraction should be performed as additional refractive error may be uncovered, particularly in younger children whose eyes are still developing. 1
Answer: A. Convex lenses