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A longitudinal study of a population based sample of astigmatic children. II. The changeability of anisometropia
M Abrahamsson1, G Fabian, J Sjöstrand
1Department of Ophthalmology, University of Göteborg, Sweden.
Insights
Anisometropia in children aged 1-4 years often resolves, but persistent cases carry a risk of amblyopia. Non-persisting anisometropia is typically benign in emmetropizing eyes.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Anisometropia, a difference in refractive error between the eyes, is a concern in pediatric vision development.
- Understanding the longitudinal changes in anisometropia is crucial for early detection and intervention.
Purpose of the Study:
- To investigate the longitudinal variability of anisometropia in children from 1 to 4 years of age.
- To determine the risk of amblyopia associated with persistent versus non-persistent anisometropia.
Main Methods:
- A longitudinal study of 310 children with astigmatism, initially aged 1 year.
- Regular assessments of anisometropia over a 3-year period (ages 1-4).
- Analysis of individual case trajectories and association with amblyopia and strabismus.
Main Results:
- The prevalence of anisometropia (≥1 D) remained relatively stable year to year.
- Less than half of anisometropic cases persisted throughout the 3-year study period.
- Children with persistent anisometropia had a significant risk (approx. 25%) of developing amblyopia.
- No clear link was found between anisometropia at specific ages and later amblyopia or strabismus.
Conclusions:
- Transient anisometropia in emmetropizing eyes is usually benign and does not increase the risk of amblyopia.
- Persistent anisometropia during early childhood is a risk factor for amblyopia development.
- Monitoring anisometropia is important, especially in cases that do not resolve spontaneously.
Abstract:
The variability of anisometropi in a sample of 310 children with astigmatism at the age of 1 year was longitudinally studied during a 3-year period between 1 and 4 years of age. The prevalence of anisometropia of 1 D or more at each year level was rather stable. When individual cases were examined we found that between the first and the last test session 19 of the 33 children with anisometropia at the first test session had become non-anisometropic and were substituted with 14 new cases which were non-anisometropic at the age of 1 year. In general, less than half of the cases, at all levels of anisometropia, remained anisometropic throughout the whole test period. We also found that children with anisometropia persisting through the whole test period were at considerable risk, about one out of four, of developing amblyopia. There was no simple relationship, however, between anisometropia at a certain age level between 1 and 4 years and amblyopia and/or strabismus. Non-persisting anisometropia in an emmetropizing eye is in most cases a benign sign and not connected with an increased risk for developing amblyopia.