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Emmetropization during Early Childhood

  • Yvette Schein
    Affiliations
    Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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  • Yinxi Yu
    Affiliations
    Scheie Eye Institute, Center for Preventive Ophthalmology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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  • Gui-shuang Ying
    Affiliations
    Scheie Eye Institute, Center for Preventive Ophthalmology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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  • Gil Binenbaum
    Correspondence
    Correspondence: Gil Binenbaum, MD, MSCE, Division of Ophthalmology, Children’s Hospital of Philadelphia, 3401 Civic Center Boulevard, CHOP 9-MAIN, Philadelphia, PA 19104.
    Affiliations
    Division of Ophthalmology, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

    Scheie Eye Institute, Center for Preventive Ophthalmology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania
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Published:November 29, 2021DOI:https://doi.org/10.1016/j.ophtha.2021.11.021
      Refractive error (RE) in infants is expected to decrease over time, a process known as emmetropization. The degree, timing, and rate of emmetropization have been hypothesized to be affected by infant age and initial RE. Investigators have identified faster rates of emmetropization among infants with greater initial RE.
      • Saunders K.J.
      • Woodhouse J.M.
      • Westall C.A.
      Emmetropisation in human infancy: rate of change is related to initial refractive error.
      ,
      • Ehrlich D.L.
      • Braddick O.J.
      • Atkinson J.
      • et al.
      Infant emmetropization: longitudinal changes in refraction components from nine to twenty months of age.
      The American Academy of Ophthalmology (AAO) recommends glasses prescription for defined ranges of RE at specific ages, assuming that many children will undergo emmetropization as they age.
      American Academy of Ophthalmology
      Pediatric eye evaluations Preferred Practice Pattern.
      These recommendations are based largely on expert consensus, and variations in applying these recommendations exist among providers.
      American Academy of Ophthalmology
      Pediatric eye evaluations Preferred Practice Pattern.
      ,
      • Dawson L.
      • Huang J.
      • Binenbaum G.
      Pediatric ophthalmologist glasses prescribing patterns.
      Some ophthalmologists delay giving glasses, anticipating more emmetropization. We examined emmetropization during early childhood to understand better what proportion of children with high RE in infancy subsequently undergo emmetropization to a degree that changes clinical management and to help ophthalmologists make more informed decisions about prescribing glasses during infancy.

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