ClinicalTrials.gg
CompletedNCT03669146Updated Jul 9, 2024Results posted

Enhancement of Emmetropization in Highly Hyperopic Infants

An interventional study of Glasses in Hyperopia, sponsored by Donald O Mutti, OD, PhD. Completed at 1 site in United States. Open to participants aged 8 Weeks to 15 Weeks, including healthy volunteers. Per ClinicalTrials.gov, last updated 2024-07-09.

Sponsored by Donald O Mutti, OD, PhD · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
35
Allocation
Randomized
Ages
8 Weeks to 15 Weeks
Sex
All
01

Study summary

Infants do not usually wear glasses because they usually do not need them to see clearly. Most infants are born with a moderate amount of farsightedness. Most infants then undergo a natural process called 'emmetropization' that reduces the amount of farsightedness. However, up to 10% of infants don't emmetropize and end up with very farsighted prescriptions. Farsighted infants must use extra focusing effort to see clearly, which may make their eyes cross and perhaps cause a "lazy eye". If infants avoid this effort and their vision stays blurred into childhood, they may develop two lazy eyes. Farsightedness in school-aged children makes reading and learning more difficult. New studies in animals and in humans show that infant eyes will emmetropize best if they have just a normal, moderate amount of farsightedness. The infant eye must be in this normal target zone in order to emmetropize. If a baby were given glasses with the full prescription to correct all of his farsightedness, the eyes would also be out of the target zone and would not receive any signal to grow. The best strategy might be to give a partial spectacle correction for the farsightedness, just enough to put them in the zone that is most effective for emmetropization.

The purpose of this project is to determine if emmetropization can be enhanced in very farsighted babies. We will give them glasses with a partial correction and accommodative (eye focusing) training. The partial correction is an amount that is less than their full degree of farsightedness but enough to put them in the zone of effective emmetropization. As changes in farsightedness occur, the power of the glasses will be reduced to keep the farsightedness within the target zone. If an infant reaches a normal amount of farsightedness, the glasses will be discontinued. The comparison group will be farsighted babies who receive the current standard of care, namely no correction. The main outcome of the study will be whether there is a significant difference in the decrease of farsightedness between the two groups when the infants are 18 months of age.

If emmetropization can be enhanced in very farsighted babies, the risk of developing crossed or lazy eye will be reduced. The lifelong need for spectacles, contact lenses, or refractive surgery for high amounts of farsightedness would also be reduced. Positive results might also make infant eye examinations more common and place a new therapeutic option in clinicians' hands.

02

Conditions studied

  • Hyperopia

Keywords

  • Emmetropization
  • Refractive Error
  • Glasses
  • Accommodation
03

In context

Hyperopia

156 studies on the registry are indexed under Hyperopia; 20 are open to participants now.

This study's enrollment of 35 is below the median of 60 across 125 interventional studies indexed under Hyperopia.

Browse Hyperopia studies →

Lead sponsor

This is the only study on the registry with Donald O Mutti, OD, PhD as lead sponsor.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
8 Weeks to 15 Weeks
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age: between 8 and 15 weeks at baseline examination
  • Either gender
  • Any ethnicity
  • Birthweight greater than 2500g
  • Normal pregnancy and delivery (including Cesarean section delivery but excluding serious complications or conditions such as eclampsia or rubella)
  • Hyperopia greater than or equal to +5.00 Diopters (D) in the spherical component of refractive error in one or both eyes measured with cycloplegic retinoscopy using 1% cyclopentolate
  • Infants with a refractive error of greater than or equal to +5.00D but less than or equal to +7.00D in the spherical component of refractive error will be randomized to treatment (partial correction with accommodative training) or observation only.
  • Infants with greater than +7.00D in the spherical component of refractive error will receive treatment

Exclusion criteria

Exclusion Criteria:

  • Astigmatism greater than 2.00D in either eye
  • Anisometropia greater than 1.50D (spherical equivalent)
  • History of strabismus surgery
  • History of difficulty with pupillary dilation
  • History of cardiac, liver, asthma, or other respiratory disease
  • History of ocular disease, retinal detachment, severe macular dragging, intraocular surgery, optic nerve hypoplasia, malformations of the eye, cortical visual impairment or active inflammation
  • History of hydrocephalus, Down syndrome, cerebral palsy, developmental delay, seizure disorders
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Care provider)
Enrollment
35 participants (actual)

Study arms

  • Experimental
    Hyperopic subjects receiving glasses

    Randomized +5.00 to +7.00 diopter hyperopic subjects that will receive partial refractive correction and will be instructed to do accommodation exercises on a daily basis.

    Device: Glasses

  • No intervention
    Hyperopic subjects uncorrected

    Randomized +5.00 to +7.00 diopter hyperopic subjects that will serve as the control to the experimental arm who will receive no correction but be observed for the duration of the study.

  • Active comparator
    Highly hyperopic subjects corrected

    If a subject is found to be greater than +7.00 diopters hyperopic during the screening phase of the study, they will receive glasses correction and be followed during the study period.

    Device: Glasses

Interventions

  • DeviceGlasses

    Partial refractive correction in a pair of glasses.

06

What researchers measure

Primary outcomes

  1. Central Cycloplegic Refractive Error With Retinoscopy

    The subject's central refractive error will be measured (in Diopters) with cycloplegic retinoscopy to determine if partial refractive correction and accommodative training can enhance emmetropization in highly hyperopic infants. Successful enhancement is defined as being an average of 1.75 Diopters less hyperopic than control subjects at 18 months.

    Time frame: 18 months

Secondary outcomes

  1. Peripheral Cycloplegic Refractive Error With SureSight Autorefractor

    The subject's central and peripheral refractive error will be measured (in Diopters) with the SureSight autorefractor to determine if partial refractive correction and accommodative training can enhance emmetropization through modulation of ocular shape in highly hyperopic infants.

    Time frame: 18 months

  2. Accommodative Response With PowerRefractor

    The subject's accommodative ability will be measured objectively with a PowerRefractor autorefractor to determine determine if partial refractive correction and accommodative training can enhance emmetropization through modulation of accommodation in highly hyperopic infants.

    Time frame: 18 months

07

Results

Posted Jul 9, 2024
Limitations and caveats
Small number of participants analyzed.

Participant flow

Participant flow — Overall Study
MilestoneHyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects Corrected
Started15155
Completed13145
Not completed210

Outcome measures

PrimaryCentral Cycloplegic Refractive Error With Retinoscopy

The subject's central refractive error will be measured (in Diopters) with cycloplegic retinoscopy to determine if partial refractive correction and accommodative training can enhance emmetropization in highly hyperopic infants. Successful enhancement is defined as being an average of 1.75 Diopters less hyperopic than control subjects at 18 months.

Time frame:
18 months
Reported as:
Mean · Diopters
Central Cycloplegic Refractive Error With Retinoscopy
DioptersHyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects Corrected
Central Cycloplegic Refractive Error With Retinoscopy1.6 ± 0.61.2 ± 0.72.8 ± 1.2
SecondaryPeripheral Cycloplegic Refractive Error With SureSight Autorefractor

The subject's central and peripheral refractive error will be measured (in Diopters) with the SureSight autorefractor to determine if partial refractive correction and accommodative training can enhance emmetropization through modulation of ocular shape in highly hyperopic infants.

Time frame:
18 months
Reported as:
Mean · Diopters
Peripheral Cycloplegic Refractive Error With SureSight Autorefractor
DioptersHyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects Corrected
Central Spherical Equivalent Refractive Error2.15 ± 0.611.99 ± 1.184.11 ± 1.11
Relative Nasal Spherical Equivalent Refractive Error-0.28 ± 0.89-0.19 ± 0.6-0.52 ± 0.25
Relative Temporal Spherical Equivalent Refractive Error-1.25 ± 1.17-0.81 ± 0.77-2.21 ± 0.61
SecondaryAccommodative Response With PowerRefractor

The subject's accommodative ability will be measured objectively with a PowerRefractor autorefractor to determine determine if partial refractive correction and accommodative training can enhance emmetropization through modulation of accommodation in highly hyperopic infants.

Time frame:
18 months
Reported as:
Mean · Diopters
Accommodative Response With PowerRefractor
DioptersHyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects Corrected
Accommodative Response With PowerRefractor2.21 ± 0.002.09 ± 0.221.97 ± 0.23

Adverse events

Collected over 15 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Hyperopic Subjects Receiving Glasses0/15 (0%)0/15 (0%)0/15 (0%)
Hyperopic Subjects Uncorrected0/15 (0%)0/15 (0%)0/15 (0%)
Highly Hyperopic Subjects Corrected0/5 (0%)0/5 (0%)0/5 (0%)

Baseline characteristics

Age, Continuous
Age, Continuous(Days)Hyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects CorrectedTotal
Mean81.9 ± 10.279.0 ± 9.078.6 ± 8.780.2 ± 9.3
Sex: Female, Male
Sex: Female, Male(Participants)Hyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects CorrectedTotal
Female97420
Male68115
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Hyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects CorrectedTotal
Hispanic or Latino0000
Not Hispanic or Latino1515535
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Hyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects CorrectedTotal
American Indian or Alaska Native0000
Asian0000
Native Hawaiian or Other Pacific Islander0000
Black or African American0011
White1415433
More than one race1001
Unknown or Not Reported0000
Region of Enrollment
Region of Enrollment(participants)Hyperopic Subjects Receiving GlassesHyperopic Subjects UncorrectedHighly Hyperopic Subjects CorrectedTotal
United States1515535
08

Study locations

1 site
  • The Ohio State University
    Columbus, Ohio 43210, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 9, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03669146
Lead sponsor
Donald O Mutti, OD, PhD
Responsible party
Donald O Mutti, OD, PhD (Professor, Ohio State University) — Sponsor-investigator
First posted
Sep 13, 2018
Start date
Apr 24, 2019
Primary completion
Jan 5, 2023
Completion
Jan 5, 2023
Results posted
Jul 9, 2024
Last update
Jul 9, 2024

Study contacts

Donald O Mutti, OD, PhD
principal investigator · Ohio State University
Ann M Morrison, OD, PhD
study chair · Ohio State University

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jun 2024. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion