A 7-year-old child has cycloplegic refraction of +5.00 DS in both eyes. There is 2 PD of esophoria at near and 3 PD of esophoria at distance. The child is asymptomatic. What is the recommended management?

• A Prescribe full cycloplegic correction (+5.00 DS)
• B Prescribe atropine penalization instead of glasses
• C Observe without glasses unless esotropia develops
• D Prescribe partial correction, leaving +1.50 to +2.00 D uncorrected ✓

Explanation

In children aged 1-7 years with hypermetropia between +4.0 and +7.0 B without esotropia, partial correction is recommended. The goal is to reduce the hypermetropic correction by 1.50 to 2.00 B to maintain some accommodative stimulus and prevent weakening of convergence. Full correction may cause blurring at near due to reduced accommodative demand. Observation alone risks amblyopia if significant refractive error remains uncorrected.

Reference: Pediatric Ophthalmology and Strabismus (AAO BCSC), 2023-2024 ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.