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Refractive Errors and Concomitant Strabismus: A Systematic Review and Meta-analysis.

Shu Min Tang1, Rachel Y T Chan1, Shi Bin Lin2

  • 1Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong.

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|October 13, 2016
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Summary
This summary is machine-generated.

Myopia increases the risk of developing exotropia (outward turning eye). Hyperopia (farsightedness) shows a dose-related effect, significantly increasing the risk of esotropia (inward turning eye) with higher diopter values.

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Area of Science:

  • Ophthalmology
  • Public Health
  • Genetics

Background:

  • Refractive errors, including myopia, hyperopia, astigmatism, and anisometropia, are common visual conditions.
  • Strabismus, characterized by eye misalignment, can be concomitant (present when both eyes are open) or incomitant.
  • The relationship between specific refractive errors and the development of concomitant strabismus requires further clarification.

Purpose of the Study:

  • To systematically review and meta-analyze the risk of developing concomitant exotropia and esotropia associated with refractive errors.
  • To identify specific refractive errors that act as independent risk factors for these types of strabismus.

Main Methods:

  • A systematic literature search was conducted in MEDLINE and EMBASE for studies published from 1946 to April 1, 2016.
  • Studies evaluating refractive errors as independent risk factors for concomitant exotropia and esotropia were included.
  • Data from 7 population-based studies involving 23,541 participants were pooled for meta-analysis.

Main Results:

  • Myopia was confirmed as a significant risk factor for concomitant exotropia (Odds Ratio [OR]: 5.23, P < 0.0001).
  • Hyperopia demonstrated a strong, dose-related association with concomitant esotropia.
  • Increasing levels of hyperopia (spherical equivalent) showed progressively higher risks: 2-3D (OR: 10.16), 3-4D (OR: 17.83), 4-5D (OR: 41.01), and ≥5D (OR: 162.68).

Conclusions:

  • Myopia is a confirmed risk factor for the development of concomitant exotropia.
  • Hyperopia presents a significant, dose-dependent risk for developing concomitant esotropia.
  • These findings underscore the importance of refractive error correction in managing and potentially preventing certain types of strabismus.