Isoametropic amblyopia in highly hyperopic children

Abstract

. Purpose: The purpose of this study was to evaluate the visual outcome and associated findings in isoametropic amblyopia due to high hyperopia. Methods: Children with ≥ 5 D spherical equivalent hyperopia and ≤ 1.5 D anisometropia and ≤ 1.5 D cylinder in both eyes were selected. Data were collected on the magnitude of spherical equivalent hyperopia, corrected visual acuity (VA) with the Snellen or Tumbling E charts, age at correction, duration of correction, ocular motility and strabismus. Children who had VA of ≤ 0.4 in both eyes were defined as having isoametropic amblyopia. Associations between isoametropic amblyopia and factors affecting VA were analysed. Results: A total of 160 children met the criteria. The mean follow‐up was 55.8 months. In all, 31 of the children had isoametropic amblyopia. The mean age at presentation was significantly higher (5.5 years versus 4.1 years; p < 0.05) and strabismus was significantly less prevalent (p = 0.001) in the isoametropic amblyopes than in the high hyperopia group as a whole. A total of 83.9% of the isoametropic amblyopes had best corrected VA > 0.5 at the last visit. The duration of optical correction was positively correlated with the last recorded VA measurement. Conclusion: Isoametropic amblyopia is not rare among highly hyperopic children. Visual acuity improves satisfactorily with spectacle correction. The duration of optical correction seems to be an important factor in visual prognosis.

Properties of Pediatric Patients with Bilateral Amblyopia

“…The mean age of our patients at admission was 7.04±2.30 (min: 3, max: 13) years. It is reported as 5 years 1 month-5 years 6 months (3,7,8) in other studies of patients with isoametropic amblyopia with hypermetropia of >5 D. The mean sphere measured was also higher in these studies (5.92-6.25 D vs. +2.98±0.93 D in our study) as expected because patients with relatively lower levels of hypermetropia were also enrolled in our study. However, the mean cylindrical refractive error of our patients was +1.28±0.57 D, similar to other studies (1.36 D) (7,8).…”

“…This is higher in comparison with the levels of other studies (0.34-0.35) (7,8). Increased hypermetropia is reported to be associated with decreased visual acuity (7), no change in visual acuity (5,8), and increased visual acuity too (9).…”

“…Strabismus concomitant with bilateral amblyopia has previously been reported in 13-64% of patients (7)(8)(9). In our study, 41.5% of the patients had strabismus.…”

Anisometropia, Ametropia and Amblyopia and Their Effect on Near Visual Acuity

“…Amblyopia due to bilateral high refractive error (ametropic amblyopia) result from large, approximately equal, uncorrected refractive error in both eyes of a young child [3,4]. An error of +5 D is needed in both eyes for hypermetropic ametropic amblyopia and -8 D for myopic ametropic amblyopia [3].…”

“…An error of +5 D is needed in both eyes for hypermetropic ametropic amblyopia and -8 D for myopic ametropic amblyopia [3].…”