Anisometropia in Children from Infancy to 15 Years

PURPOSE. To investigate anisometropia in children from age 6 months to 15 years. METHODS. Children with refractions at 6 months (n = 1120), 5 years (n = 395), and 12 to 15 years (n = 312) were included in this study. All children were refracted in the laboratory by noncycloplegic retinoscopy. Myopes had spherical equivalent refraction (SER) of the less ametropic eye of less than -0.50 D, hyperopes had SER of the less ametropic eye greater than or equal to 1.00 D, and emmetropes had SER of the less ametropic eye from -0.50 to +1.00 D. RESULTS. The mean difference in refraction between the two eyes was similar at 6 months (0.11 D) and 5 years (0.15 D), increasing to 0.28 D at 12 to 15 years. Using a cutoff of 1.00 D SER for anisometropia, the prevalence was 1.96%, 1.27%, and 5.77% at 6 months, 5 years, and 12 to 15 years, respectively. At 12 to 15 years, the prevalence of anisometropia in the myopes was 9.64% and in the hyperopes was 13.64%, both significantly higher than that in the emmetropes (3.38%, P < 0.05). The degree of anisometropia at 12 to 15 years was significantly associated with the refractive error of the less ametropic eye at 12 to 15 years, with and without adjustment for relevant covariates (P < 0.05). Infants with significant astigmatism (cylinder power >= 1.00 D in one or both eyes) have an increased risk of anisometropia (P < 0.05). CONCLUSIONS. The prevalence of anisometropia increases between 5 and 15 years, when some children's eyes grow longer and become myopic. However, anisometropia was found to accompany both myopia and hyperopia, suggesting that other mechanisms in addition to excessive eye growth may exist for anisometropia development, especially in hyperopia. (Invest Ophthalmol Vis Sci. 2012;53:3782-3787) DOI:10.1167/iovs.11-8727