While the following data supporting the statement about the high proportion of children with uncorrected refractive error did not appear in the original article,1 we appreciate the opportunity to respond to the comments made by Drs Brown and Donahue. The data below are based on our definitions of refractive error presented in our article, with correction defined as refractive correction in place (ie, spectacles or contact lenses) when a child’s visual acuity was measured. The Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (CLEERE) Study protocol dictates that corrected visual acuity be measured for all children who were examined with correction during the CLEERE Study visit. This does not mean that the correction was appropriate or current. It only indicates that the student was wearing refractive correction. This could overestimate the proportion of children who were optimally corrected in our study. On the other hand, the estimate of children with uncorrected refractive error also includes those children who left their glasses in the classroom or at home or who had recently lost or broken their spectacles, thereby potentially increasing the proportion classified as uncorrected. We acknowledge these limitations to the data set but would venture to say that a child who does not bring his or her refractive correction to an eye examination is probably not a compliant user of that refractive correction.
Jones LA, Kleinstein RN, Mutti DO, Zadnik K, CLEERE Study Group. Hyperopia: How Do We Define Abnormal?—Reply. Arch Ophthalmol. 2005;123(1):125. doi:10.1001/archopht.123.1.125-a