The role of anisometropia in the development of accommodative esotropia

David R. Weakley, Eileen Birch, Kevin Kip

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Abstract

Purpose: To determine whether anisometropia increases the risk for the development of accommodative esotropia 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 accommodative esotropia and of developing unsatisfactory control with spectacles once esotropia was present. Results: Anisometropia (≥1 D) increased the relative risk of developing accommodative esotropia 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 accommodative esotropia, especially in patients with lower overall hypermetropia (>+3.00 D). Anisometropia also increases the risk that an accommodative esotropia will not be satisfactorily aligned with spectacles.

Original languageEnglish (US)
Pages (from-to)153-157
Number of pages5
JournalJournal of AAPOS
Volume5
Issue number3
DOIs
StatePublished - Jun 2001

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Anisometropia
Esotropia
Hyperopia
Refractive Errors

ASJC Scopus subject areas

  • Ophthalmology

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The role of anisometropia in the development of accommodative esotropia. / Weakley, David R.; Birch, Eileen; Kip, Kevin.

In: Journal of AAPOS, Vol. 5, No. 3, 06.2001, p. 153-157.

Research output: Contribution to journalArticle

Weakley, David R. ; Birch, Eileen ; Kip, Kevin. / The role of anisometropia in the development of accommodative esotropia. In: Journal of AAPOS. 2001 ; Vol. 5, No. 3. pp. 153-157.
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abstract = "Purpose: To determine whether anisometropia increases the risk for the development of accommodative esotropia 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 accommodative esotropia and of developing unsatisfactory control with spectacles once esotropia was present. Results: Anisometropia (≥1 D) increased the relative risk of developing accommodative esotropia 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 accommodative esotropia, especially in patients with lower overall hypermetropia (>+3.00 D). Anisometropia also increases the risk that an accommodative esotropia will not be satisfactorily aligned with spectacles.",
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