Anisometropia Amblyopia and Reduced Stereoacuity in School-Aged Population with High Prevalence of Astigmatism

Associations between Anisometropia, Amblyopia, and Reduced Stereoacuity in a School-Aged Population with a High Prevalence of Astigmatism
Velma Dobson, Joseph M. Miller, Candice E. Clifford-Donaldson, Erin M. Harvey


To describe the relation between magnitude of anisometropia and interocular acuity difference (IAD), stereoacuity (SA), and the presence of amblyopia in school-aged membersof a Native American tribe with a high prevalence of astigmatism.
Refractive error (cycloplegic autorefraction confirmed by retinoscopy), best corrected monocular visual acuity (VA; Early Treatment Diabetic Retinopathy Study logMAR charts), and best corrected SA (Randot Preschool Stereoacuity Test) were measured in 4- to 13-year-old Tohono O’odham children (N 972). Anisometropia was calculated in clinical notation (spherical equivalent and cylinder) and in two forms of vector notation that take into account interocular differences in both axis and cylinder magnitude.
Astigmatism 1.00 D was present in one or both eyes of 415 children (42.7%). Significant increases in IAD and presence of amblyopia (IAD2 logMAR lines) occurred, with 1D of hyperopic anisometropia and 2 to 3D of cylinder anisometropia.
Significant decreases in SA occurred with 0.5D of hyperopic, myopic, or cylinder anisometropia. Results for vector notation depended on the analysis used, but also showed disruption of SA at lower values of anisometropia than were associated with increases in IAD and presence of amblyopia.
Best corrected IAD and presence of amblyopia are related to amount and type of refractive error difference (hyperopic, myopic, or cylindrical) between eyes. Disruption of best corrected random dot SA occurs with smaller interocular differences than those producing an increase in IAD, suggesting that the development of SA is particularly dependent on similarity of the refractive error between eyes.
Invest Ophthalmol Vis Sci. 2008;49:4427–4436) DOI:10.1167/iovs.08-1985

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