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Atypical fixation preference with anisometropia.

Robert P Rutstein¹, Mark W Swanson

¹School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama 35294-0010, USA. rrutstein@icare.opt.uab.edu

Optometry and Vision Science : Official Publication of the American Academy of Optometry

|September 18, 2007

Summary

Strabismus and amblyopia in a child with hyperopia and anisometropia occurred in the less hyperopic eye. This case highlights that these conditions do not always affect the more ametropic eye.

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Area of Science:

Ophthalmology
Pediatric Ophthalmology
Strabismology

Background:

Anisometropia, a significant refractive error difference between eyes, can lead to amblyopia and strabismus.
Hyperopia, or farsightedness, is a common refractive error in children.

Observation:

A 6-year-old child presented with a history of strabismus and refractive error since infancy.
Examination revealed 3 diopters of hyperopic anisometropia, intermittent exotropia, and amblyopia.
Strabismus and amblyopia were observed in the less hyperopic eye, contrary to typical presentations.

Findings:

The child's ocular health was normal, confirmed by optical coherence tomography.
Following patching therapy, there was an improvement in the amblyopic eye's vision.
This case demonstrates an atypical manifestation of strabismus and amblyopia.

Implications:

This case challenges the conventional understanding that amblyopia and strabismus solely affect the more ametropic eye in cases of anisometropia.
It underscores the importance of a thorough ophthalmological examination in children with refractive errors and strabismus.
Further research may be warranted to explore the mechanisms behind atypical amblyopia and strabismus development in anisometropia.