EMMETROPIZATION AND THE PROGRESSION OF MANIFEST REFRACTION IN CHILDREN FOLLOWED FROM INFANCY TO PUBERTY

1. The manifest refractions of 72 children were tracked at regular int ervals starting soon after birth and continuing for 9-16 y. Near-retin oscopy, a non-cycloplegic refraction technique, was used for children aged 0-3 y, and non-cycloplegic distance retinoscopy after 3 y. Almost 1400 refractions have been obtained from this group. 2. During the fi rst 6 months the mean spherical equivalent of the group is negative by a small amount. By one year of age the children have an average of 0. 5 D of hyperopia which they maintain until 8 y. After 11 y the mean sp herical equivalent once again becomes negative, largely because some o f the children are becoming myopic. 3. The dispersion of refractions i s largest shortly after birth and smallest at 6 y, reflecting the proc ess of emmetropization during the preschool years. 4. The spherical eq uivalent at 1 y is most predictive of later spherical equivalents. Cor relations of spherical equivalent at 1 y with other ages range from 0. 43 during the period of emmetropization to 0.76 at some later ages. 5. Children with a negative spherical equivalent in infancy in conjuncti on with either against-the-rule astigmatism or no astigmatism are more likely to be myopic at school age than children with infantile with-t he-rule astigmatism. 6. There is an increased incidence of myopia in c hildren with two (compared to zero or one) myopic parents.