Purpose: Using the Titmus stereo test to examine the association between hyperopic ametropia including
hyperopia, astigmatism, anisometropia, and stereoacuity in a school-aged population.
Methods: We measured cycloplegic autorefraction, best corrected monocular visual acuity and best
corrected stereoacuity in a population of 4- to 13-year-old school-aged children (Keelung, Taiwan) after
obtaining proper informed consent. Children with amblyopia (best-corrected visual acuity inferior to
20/25) or strabismus were excluded from the study. The effects of the severity of hyperopia, astigmatism,
and anisometropia on stereoacuity revealed by the Titmus stereo test were analyzed.
Results: One hundred and seventeen children (51 boys and 66 girls; mean age¼ 7.32 years, range¼ 4e13
years) with hyperopia were enrolled into the study. The mean spherical error was þ1.48 1.30 diopters
(D) (range¼þ0.25 to þ6.50D). The mean astigmatism was -1.22 1.04 D (range ¼ 0 to -3.50 D). They
received the Titmus stereo test. A spherical error > þ3.00 D and spherical equivalent > þ3.00 D showed
a strong association with decreased stereoacuity in the Titmus stereo test (p ¼ 0.000). The degree of
astigmatism or astigmatic anisometropia was not significantly correlated with the stereopsis in the test.
Conclusion: The Titmus stereo test revealed a good quantification of the stereoacuity. A spherical error
> þ3.00 D, and a spherical equivalent > þ3.00D were all associated with a significantly reduced stereoacuity
in school-aged children.
