Reply to Letter to Editor: Overminus Lens Therapy in the Management of Children with Intermittent Exotropia

We acknowledge and appreciate Singh et al. for their interest in our recently published article entitled “Overminus lens therapy in the management of children with intermittent exotropia”1 and would like to take this opportunity to address the queries and doubts raised by them. Regarding the cutoff point for the age of younger children, we had mentioned that the amount of the overcorrection was determined by the maximum tolerated lens power. The maximum tolerated lens was chosen based on the children’s capability to read 20/25 at distance and near fixation. Other children without this capability were considered younger children. Therefore, the definition of a cutoff point for the age of this subgroup of the children was not logical and could decrease the accuracy of the study. In addition, Singh et al. discussed possible nonhomogeneities between this subgroup of patients with elder children. As we list in the limitations of the study, “the accurate determination of the deviation is not generally possible in very young children, so the decrease of deviation in the course of the present study may be due to measurement error”. In addition, Bayramlar et al.2 described a similar methodology in their study.