Emmetropization during Early Childhood

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. 1 Saunders K.J. Woodhouse J.M. Westall C.A. Emmetropisation in human infancy: rate of change is related to initial refractive error. Vision Res. 1995; 35: 1325-1328 Google Scholar ,2 Ehrlich D.L. Braddick O.J. Atkinson J. et al. Infant emmetropization: longitudinal changes in refraction components from nine to twenty months of age. Optom Vis Sci Off Publ Am Acad Optom. 1997; 74: 822-843 Google Scholar 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. 3 American Academy of OphthalmologyPediatric eye evaluations Preferred Practice Pattern. https://www.aao.org/preferred-practice-pattern/pediatric-eye-evaluations-ppp-2017Date: 2017 Google Scholar These recommendations are based largely on expert consensus, and variations in applying these recommendations exist among providers. 3 American Academy of OphthalmologyPediatric eye evaluations Preferred Practice Pattern. https://www.aao.org/preferred-practice-pattern/pediatric-eye-evaluations-ppp-2017Date: 2017 Google Scholar ,4 Dawson L. Huang J. Binenbaum G. Pediatric ophthalmologist glasses prescribing patterns. Invest Ophthalmol Vis Sci. 2014; 55 (4486–4486) Google Scholar 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.