A survey of prescribing philosophy in childhood hyperopia among optometrists in Ghana

Clinical Relevance
Hyperopia is a common refractive error in young children and has the potential to affect their visual, educational and general development. Management of childhood hyperopia presents significant intra-and inter-professional differences partly because evidence-based guidelines to inform when and how to prescribe for hyperopia are insufficient.

Purpose
This study investigated the prescribing philosophy in childhood hyperopia among optometrists in Ghana and the challenges faced in managing childhood hyperopia.

Methods
An online questionnaire was distributed to optometrists in Ghana to evaluate the prescribing philosophy in childhood hyperopia. The questionnaire assessed factors, which could influence prescribing patterns in participants including age, symptoms, emmetropisation, and magnitude of hyperopia in patients. Challenges encountered in the management of childhood hyperopia in children were also investigated.

Results
Ninety-one optometrists responded to the questionnaire with the mean age of participants being 32.3 ± 5.6 years. Most participants (67,(74%)) surveyed reported using some clinical guidelines in the management of childhood hyperopic refractive errors. The magnitude of bilateral hyperopia that practitioners were willing to prescribe decreased with increasing age of the patient (p < 0.0001). Most participants preferred modification of the amount of bilateral hyperopia found during cycloplegic refraction and also indicated a preference for prescribing a lesser amount of astigmatism. Lack of instrumentation for paediatric assessment was the main challenge reported in the management of hyperopic refractive errors.

Conclusion
The spectacle prescribing philosophies in childhood hyperopia amongst optometrists in Ghana largely follow existing clinical guidelines, although, in some instances, there were mismatches between the existing guidelines and their preferred pattern. Regular continuing professional development, which highlights emerging evidence on prescribing in childhood hyperopia, would be desirable.