Long-term Changes in Refractive Error after Spectacle Use

PURPOSE: To evaluate the long-term changes in spherical equivalent (SE) refractive error and astigmatism in patients after spectacle use. METHODS: A total of 103 patients with refractive error without strabismus and amblyopia who received at least 3 years of follow-up after using spectacles were included in this study. Patients were divided into groups according to the age at which spectacles were used (+0.75 D), and the initial degree of astigmatism (<1.00 D, 1.00 to 3.00 D, ≥ 3.00 D). Changes in the SE refractive error and astigmatism were compared between these groups using mixed linear models.. RESULTS: Patients were followed up for a mean of 9.1 ± 1.6 years. An overall negative shift in SE refractive error and an increasing tendency in astigmatism during follow-up were noted regardless of the age at which spectacles were used (p < 0.001). The myopic group showed the largest negative shift in SE and the largest increase in astigmatism (p < 0.001, p = 0.02 respectively). The low and moderate astigmatism groups were more likely to have significant increases in astigmatism (p < 0.001). CONCLUSIONS: Patients with refractive error showed a negative shift in SE and an increasing tendency in astigmatism regardless of the age at which spectacles were used. Changes in SE and astigmatism may be influenced by the initial degree of SE, and the initial degree of astigmatism may influence changes in astigmatism.

Long-Term Follow-Up of Refractive Accommodative Esotropia: Decompensation and Cessation of Spectacle Use

PURPOSE: To analyze clinical characteristics of refractive accommodative esotropia related with the occurrence of decompensation and cessation of spectacle use. METHODS: The records of 60 patients with refractive accommodative esotropia were reviewed. Patients were divided into a control or decompensation group. Twenty-nine patients in the control group who were followed up for long-term were divided into two groups based on spectacle use. RESULTS: In the decompensation group, the amounts of near and distant esodeviation without correction at the first visit and the frequency of failure to achieve central fusion were significantly greater than the control group (p 0.05). In the group that no longer required glasses, the age at the first visit was greater and the amount of hyperopia and the near and distant esodeviations without correction at the first visit were significantly greater than the glasses-wearing group (p 0.05). CONCLUSIONS: In refractive accommodative esotropia, a larger amount of esodeviation at the first visit and failure to achieve central fusion are risk factors for developing decompensation. The older age at diagnosis and smaller amounts of hyperopia and esodeviation at the first visit are predictive factors for the cessation of spectacle use.