Hypermetropia in children and its clinical features
Authors:   S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, Saint Petersburg, Russian Federation, Somov E. E. ,   St. Petersburg Medical University of the Ministry of Health of Russia, St. Petersburg, Russian Federation, Alexandrova J. L. ,   S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, Saint Petersburg, Russian Federation,   St. Petersburg Medical University of the Ministry of Health of Russia, St. Petersburg, Russian Federation, Pavlova Y. A. ,   S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, Saint Petersburg, Russian Federation,   St. Petersburg Medical University of the Ministry of Health of Russia, St. Petersburg, Russian Federation, Kononova N. E. ,   S. Fyodorov Eye Microsurgery Federal State Institution, St. Petersburg Branch, Saint Petersburg, Russian Federation,   St. Petersburg Medical University of the Ministry of Health of Russia, St. Petersburg, Russian Federation
Published: April 2024

Purpose. Assessment of the functional state of children with hypermetropia and its performance in the visual system. Material and methods. 212 (424 eyes) somatically healthy children aged 3 to 18 years with hypermetropic refraction from 1.5±0.6 to 7.5±0.7 D were examined. They underwent standard ophthalmological examination, including visometry, refractometry, biometry and keratometry. The statistics of the material were processed according to the MS Excel 2010 program. Results. Structure of hypermetropic children for various periods of life is described in detail – congenital (against the background of normal physiology), acquired and concomitant (in various variants). In addition, the axial length of their eyes was determined in the range from 21.0 to 23.85 mm, that is, in a short range. It is also clarified that hypermetropic children can not only determine the «regular» eye accommodation tension, but also timely detect and treat functional disorders – asthenopia and/or habitually excessive accommodation voltage (described by Somov E.E. in 2012). It is also confirmed that hypermetropia is naturally accompanied by friendly strabismus (at least 90%). However, this diagnosis reveals various forms of pathology of the visual organ – deviation of the eye, ametropia, amblyopia and dysbinocularity. It can be represented by the syndrome of friendly strabismus (SFS, Somov E.E.). Two clinical forms of hypermetropia have also been identified – ordinary and complicated. The first does not require treatment, apart from optical vision correction, and the second is described in different publications, due to accommodation disorders, friendly strabismus and amblyopia. Conclusion. Hypermetropia in children is represented by a complex anatomical and clinical structure with a short axial length of the eye, weak optics, functional disorders of accommodation (asthenopia and/or habitually excessive accommodation voltage). Moreover, it naturally occurs with the syndrome of friendly strabismus. Finally, due to anatomical features, hypermetropes are able to use only «simple» vision correction: traditional glasses (~75%), contact lenses (~25%) and still rare Perifocal-H lenses. In general, these ametropes require a lot of attention, especially in conducting new research. Key words: clinical refraction of the eye, anterior-posterior eye size, keratorefractometry, accommodation, commutant esotropia, vision correction in hypermetropia