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Anisometropia in children from infancy to 15 years
1Department of Vision Science, New England College of Optometry, Boston, Massachusetts 02115, USA. dengl@neco.edu
Insights
Anisometropia prevalence increases significantly in children between ages 5 and 15. This difference in vision between eyes is linked to myopia and hyperopia, suggesting complex developmental factors beyond just eye growth.
Area of Science:
- Ophthalmology
- Pediatric Optometry
- Vision Science
Background:
- Anisometropia, a condition of unequal refractive error between eyes, can impact visual development in children.
- Understanding its prevalence and risk factors is crucial for early intervention and management.
Purpose of the Study:
- To investigate the prevalence and characteristics of anisometropia in children aged 6 months to 15 years.
- To identify associations between anisometropia and refractive errors like myopia, hyperopia, and astigmatism.
Main Methods:
- Longitudinal study including children refracted at 6 months, 5 years, and 12-15 years.
- Noncycloplegic retinoscopy used for objective refraction measurements.
- Anisometropia defined by a spherical equivalent refraction (SER) difference of ≥ 1.00 D between eyes.
Main Results:
- The mean refractive difference between eyes increased from 0.11 D at 6 months to 0.28 D at 12-15 years.
- Anisometropia prevalence was 1.96% (6 months), 1.27% (5 years), and 5.77% (12-15 years).
- Prevalence was higher in myopes (9.64%) and hyperopes (13.64%) compared to emmetropes (3.38%) at 12-15 years; significant astigmatism also increased risk.
Conclusions:
- Anisometropia prevalence rises notably between ages 5 and 15, coinciding with eye elongation and myopia development.
- The association with both myopia and hyperopia suggests multiple underlying mechanisms for anisometropia.
- Further research into these mechanisms, particularly for hyperopic anisometropia, is warranted.
Purpose:
To investigate anisometropia in children from age 6 months to 15 years.
Methods:
Children with refractions at 6 months (n = 1120), 5 years (n = 395), and 12 to 15 years (n = 312) were included in this study. All children were refracted in the laboratory by noncycloplegic retinoscopy. Myopes had spherical equivalent refraction (SER) of the less ametropic eye of less than -0.50 D, hyperopes had SER of the less ametropic eye greater than or equal to 1.00 D, and emmetropes had SER of the less ametropic eye from -0.50 to +1.00 D.
Results:
The mean difference in refraction between the two eyes was similar at 6 months (0.11 D) and 5 years (0.15 D), increasing to 0.28 D at 12 to 15 years. Using a cutoff of 1.00 D SER for anisometropia, the prevalence was 1.96%, 1.27%, and 5.77% at 6 months, 5 years, and 12 to 15 years, respectively. At 12 to 15 years, the prevalence of anisometropia in the myopes was 9.64% and in the hyperopes was 13.64%, both significantly higher than that in the emmetropes (3.38%, P < 0.05). The degree of anisometropia at 12 to 15 years was significantly associated with the refractive error of the less ametropic eye at 12 to 15 years, with and without adjustment for relevant covariates (P < 0.05). Infants with significant astigmatism (cylinder power ≥ 1.00 D in one or both eyes) have an increased risk of anisometropia (P < 0.05).
Conclusions:
The prevalence of anisometropia increases between 5 and 15 years, when some children's eyes grow longer and become myopic. However, anisometropia was found to accompany both myopia and hyperopia, suggesting that other mechanisms in addition to excessive eye growth may exist for anisometropia development, especially in hyperopia.
