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J AAPOS. 2004 Aug;8(4):310-3.

Isoametropic amblyopia due to high hyperopia in children.

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  • 1Saint Louis University, Department of Ophthalmology, Saint Louis, MO, USA. klimekdl@yahoo.com

Abstract

PURPOSE:

To identify children with isoametropic amblyopia due to moderate to high hyperopia and evaluate associated findings and visual acuity outcome.

METHODS:

Charts from two university's pediatric ophthalmology clinics were reviewed retrospectively. Healthy children with > or = +4.5 D spherical equivalent who did not have anisometropia > or = 1.5 D were selected for data collection. The charts of qualifying children with bilateral amblyopia (visual acuity of 20/40 or less) were further analyzed.

RESULTS:

Identified were 418 children with the above set of criteria for hyperopia; 36 of these children had isoametropic amblyopia (bilateral amblyopia). This gives an estimated prevalence of isoametropic amblyopia of 8.6% in children with at least 4.5 D of hyperopia in one or both eyes. The children with isoametropic amblyopia presented at a later age (5 years, 1 month) than the overall group of hyperopes (3 years, 5 months). Strabismus was less prevalent in this group (64%) than in the entire population of children with high hyperopia (81%). These children's amblyopia responded well to treatment with glasses, and patching in 13 (36%) cases. Surgical intervention for residual strabismus was necessary in very few cases (2 of 36, 5.5%).

CONCLUSION:

Children with hyperopia > or = 4.5 D have an increased risk of amblyopia and strabismus that further threatens their future visual function. Isoametropic amblyopia is a real risk in these children. Based on these results, hyperopic correction should be prescribed for children with > or = 4.5 D of hyperopia even if no strabismus or fixation preference is detected, to reduce this risk. Screening programs should also be in place to identify these children at an early age.

PMID:
15314589
[PubMed - indexed for MEDLINE]
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