"The Role of Anisometropia in the Development of Accommodative Esotropi" by David R. Weakley Jr., Eileen Birch et al.
 

The Role of Anisometropia in the Development of Accommodative Esotropia

Document Type

Article

Publication Date

6-2001

Digital Object Identifier (DOI)

https://doi.org/10.1067/mpa.2001.114662

Abstract

Purpose: To determine whether anisometropia increases the risk for the development of accommodativeesotropia with hypermetropia. Methods: Records of all new patients with a refractive error of +2.00 D or more (mean spherical equivalent of both eyes) over a 42-month period were reviewed. Three hundred forty-five patients were thus analyzed to determine the effect of anisometropia (≥1 D) on the relative risk of developing accommodativeesotropia and of developing unsatisfactory control with spectacles once esotropia was present. Results:Anisometropia (≥1 D) increased the relative risk of developing accommodativeesotropia to 1.68 (P<.05). Anisometropia (≥1 D) increased the relative risk for esotropia to 7.8 (P<.05) in patients with a mean spherical equivalent less than +3.00 D and increased it to 1.49 (P < .05) in patients with a mean spherical equivalent of +3.00 D or more (P = .016). In patients with esotropia and anisometropia (≥1 D), the relative risk for a deviation that was unsatisfactorily controlled with spectacles was 1.72 (P<.05) compared with patients with esotropia but without anisometropia. Unsatisfactorily controlled esotropia was present in 33% of patients with anisometropia versus 0% of patients without anisometropia, with a mean hypermetropic spherical equivalent of less than +3.00 D (P = .003); however, anisometropia did not significantly increase the relative risk of unsatisfactory control of esotropia with spectacles in patients with a hypermetropic spherical equivalent of +3.00 D or more. Although amblyopia and anisometropia were closely associated, anisometropia increased the relative risk for esotropia to 2.14 (P<.05), even in the absence of amblyopia. Conclusions:Anisometropia (≥1 D) is a significant risk factor for the development of accommodativeesotropia, especially in patients with lower overall hypermetropia (>+3.00 D). Anisometropia also increases the risk that an accommodativeesotropia will not be satisfactorily aligned with spectacles.

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Citation / Publisher Attribution

Journal of American Association for Pediatric Ophthalmology and Strabismus, v. 5, issue 3, p. 153-157

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