Hyperopia is a common refractive state in childhood and may represent a physiological, age-dependent stage of refractive development. However, refractive magnitude alone does not determine its clinical significance, which also depends on the child's age, associated ocular findings and functional context. This narrative review provides an overview of emmetropisation in childhood, with particular emphasis on the relationship between hyperopia, refractive development and spectacle correction. Longitudinal studies demonstrate substantial age-related changes in ocular biometry and refractive error, while baseline hyperopia may influence the subsequent refractive trajectory. Whether spectacle correction modifies emmetropisation remains uncertain. Available clinical studies differ considerably in age at treatment initiation, baseline refractive error, degree of correction and clinical phenotype, limiting direct comparisons between studies. Studies comparing spectacle correction with observation do not demonstrate a simple, universal effect of correction on emmetropisation. Current clinical guidelines also differ in their numerical thresholds for prescribing correction but consistently emphasise the importance of visual function and ocular alignment. Across the available recommendations, younger age, higher hyperopia, amblyopia risk, reduced visual acuity, anisometropia and manifest strabismus are important factors in determining whether spectacle correction is indicated. Clinical management should therefore be individualised rather than based on refractive magnitude alone. Accommodative esotropia represents an important clinical modifier requiring full hyperopic correction, whereas observation with periodic reassessment may be appropriate in selected children without significant visual dysfunction. Overall, management should balance the potential for refractive development against the risks of amblyopia, strabismus and impaired visual function.