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PubMed2006

[Assessment of tears secretion after refractive surgery].

PURPOSE: One of the complications of the corneal refractive surgery is a transient disturbance in tears secretion, which can lead to the dry eye syndrome. The aim of the study was to evaluate the tears secretion in patients after PRK, LASEK and LASIK surgery for myopia. MATERIAL AND METHODS: We examined 115 eyes of 69 patients (46 woman and 23 men), mean age 30.82, with myopia and myopic astigmatism, treated with three different refractive procedures. The patients included in this study were divided into three groups: Group I: 35 eyes of 22 patients (15 woman and 7 men) treated with PRK. The mean spherical equivalent of the refractive error was -4.18 dioptres (from -8.75 to -2.0). Group II: 41 eyes of 23 patients (13 woman and 10 men) treated with LASEK. The mean spherical equivalent of the refractive error was -5.73 dioptres (from -12.0 to -2.75). Group III: 39 eyes of 24 patients (18 woman and 6 men) treated with LASIK. The mean spherical equivalent of the refractive error was -7.49 dioptres (from -10.75 to -3.75). In this study the amount of tears secreted was analyzed on the base of Schirmer I test, performed before and after surgery. Test was always performed in the same room, in the morning hours (before noon), with constant temperature and air humidity values. RESULTS: In the PRK group the mean value of Schirmer I test was 20.91 mm before surgery. 14 days after surgery the mean value decreased to 14.09 mm, 1 month after surgery to 11.66 mm. Then increase in tears secretion was observed: 2 months after surgery the mean value of Schirmer I test was 13.94 mm, 3 months after surgery 15.23 mm, and 6 months after surgery 17.4 mm. In the LASEK group the mean value of Schirmer I test was 20.39 mm before surgery. 14 days after surgery the mean value decreased to 15.78 mm, 1 month after surgery to 13.05 mm. Two months after surgery the mean value of Schirmer I test was 15.24 mm, 3 months after surgery 16.17 mm, and 6 months after surgery 18.15 mm. In the LASIK group the mean value of Schirmer I test was 20.72 mm before surgery. 14 days after surgery the mean value decreased to 12.97 mm, 1 month after surgery to 5 mm. 2 months after surgery mean value of Schirmer I test was 12.79 mm, 3 months after surgery 15.05 mm, and 6 months after surgery 17.82 mm. CONCLUSIONS: Corneal refractive surgery causes transient reduction of tears secretion, especially during the first three postoperative months. The tears secretion was reduced most significantly in the LASIK group. In patients treated with PRK and LASEK tears secretion during the postoperative period was comparable with slightly better secretion in the LASEK patients.

Adult↗
PubMed2006

Refractive eye surgery in treating functional amblyopia in children.

PURPOSE: While excimer laser refractive surgery is recommended and highly successful for correcting refractive errors in adults, its use in children has not been extensively exercised or studied. We report our experience treating children with amblyopia due to high anisometropia, high astigmatism, high myopia and with associated developmental delay. SETTING: Review of patient records of our refractive clinic. METHODS: A retrospective review was made of all 11 children with stable refractive errors who were unsuccessfully treated non-surgically and then underwent corneal refractive surgery and in one case, lenticular surgery. Seven had high myopic anisometropia, 2 had high astigmatism, and two had high myopia--one with Down's Syndrome and one with agenesis of the corpus callosum. RESULTS: The surgical refractive treatment eliminated or reduced the anisometropia, reduced the astigmatic error, improved vision and improved the daily function of the children with developmental delay. There were no complications or untoward results. CONCLUSIONS: Refractive surgery is safe and effective in treating children with high myopic anisometropia, high astigmatism, high myopia and developmental delay due to the resulting poor vision. Surgery can improve visual acuity in amblyopia not responding to routine treatment by correcting the refractive error and refractive aberrations.

Adolescent↗
PubMed1997

Optic disc morphology in myopic primary open-angle glaucoma.

OBJECTIVE: To evaluate the morphology of the optic disc in highly myopic eyes with primary open-angle glaucoma. METHODS: Color stereo optic disc photographs of 44 patients with primary open-angle glaucoma and a myopic refractive error exceeding -8 diopters were morphometrically examined and compared with disc photographs of 571 patients with primary open-angle glaucoma and a myopic refractive error of less than -8 diopters. RESULTS: In the highly myopic group, compared to the control group, the optic disc was significantly (P < 0.0001) larger, the disc shape was significantly (P < 0.0005) more elongated, and the optic cup depth was significantly (P < 0.0001) more shallow. The loss of neuroretinal rim was more concentric, and localized retinal nerve fiber layer defects were found significantly less frequently in the highly myopic group than in the control group. In the highly myopic group, zone beta of parapapillary atrophy was significantly (P < 0.0001) larger. CONCLUSION: The optic disc morphology in primary open-angle glaucoma differs significantly between highly myopic eyes and eyes with hyperopia or low to moderate myopia. The highly myopic eyes are characterized by secondary macro-discs with elongated shape, shallow and concentric disc cupping, large parapapillary atrophy, and low frequency of localized retinal nerve fiber layer defects. Glaucomatous optic nerve damage in highly myopic eyes, compared to eyes with a normal refractive error, is more diffuse than localized.

Female↗
PubMed1999

The aging effect on corneal curvature and the validity of Javal's rule in Hong Kong Chinese.

PURPOSE: The current study compared the central corneal curvature and the refractive error of Hong Kong Chinese to study the validity of Javal's rule. METHODS: Subjects without corneal pathology were recruited at different age ranges. Their refractive error and the corneal curvature were measured and compared for the right eye only. Two instruments were used for the measurement of corneal curvature including a conventional Bausch & Lomb (B&L) keratometer and a computer-assisted videokeratoscope (TMS-1). RESULTS: Subjects age ranged from 21 years to 77 years were recruited and were categorized into five groups according to age. The Bausch & Lomb keratometer was found to provide corneal information similar to that from the TMS-1. The corneal astigmatism was found to change from with-the-rule to against-the-rule with advancing age. The spectacle astigmatism followed a similar trend. There was a hyperopic shift in the spherical component of the refractive error with aging as well. A regression equation: Spectacle astigmatism = 0.93 (Corneal astigmatism) + (-0.58D x 90) was found, which is similar to the simplified Javal's rule. There was a shift of 1.03D in hyperopia (spherical equivalent) for each decade. CONCLUSIONS: Both the corneal and spectacle astigmatism demonstrated a shift from with-the-rule to against-the-rule with age. The simplified Javal's rule is more suitable for predicting the spectacle astigmatism from corneal astigmatism in Hong Kong Chinese.

Adult↗
PubMed2003

LASIK after retinal detachment surgery.

AIM: To assess the efficacy and safety of laser in situ keratomileusis (LASIK) for correction of myopic refractive errors in eyes which have previously undergone retinal detachment surgery. METHODS: In a prospective, non-comparative case series, 10 eyes of nine patients who had a myopic refractive error and had previously undergone retinal detachment surgery underwent LASIK surgery according to the standard surgical protocol. The surgery could be completed in eight eyes and in two eyes it was aborted intraoperatively. The parameters evaluated included the uncorrected visual acuity, best corrected visual acuity, refraction, detailed fundus evaluation with indirect ophthalmoscope, slit lamp biomicroscopy, and corneal pachymetry. Any intraoperative or postoperative complications were recorded. Follow up visits were scheduled at day 1, 1 week, 1 month, 3 months, and 6 months after LASIK. RESULTS: Eight eyes underwent successful LASIK surgery. The mean spherical equivalent before surgery was -5.436 (SD 1.6) dioptres (D), which was reduced to +0.42 (0.65) D, -0.07 (1.32) D, -0.06 (1.39) D, and -0.06 (0.65) at 1 week, 1 month, 3 months, and 6 months respectively after LASIK. The uncorrected visual acuity improved in all the eyes and the best corrected visual acuity improved or remained same in all the eyes. There was no retinal complication after LASIK. CONCLUSION: LASIK may be used to correct refractive errors in eyes that have undergone retinal detachment surgery. However, scarred conjunctiva in such cases may prevent generation of optimal suction for the microkeratome.

Adult↗
PubMed2006

[Effects of experimentally induced hyperopic optical defocus on refractive status of adolescent monkeys].

OBJECTIVE: To determine if chronic optical defocus alters refractive development in monkeys at ages corresponding to the typically developed age of myopia in human children. METHODS: A hyperopic anisometropia was produced in 7 adolescent rhesus monkeys by photorefractive keratectomy (PRK). The laser procedures were performed when the monkeys were 2.0 to 2.5 years old, which corresponded to approximately 8-10 years old in human being. The ocular effects of the induced anisometropia were assessed periodically by corneal topography, retinoscopy and A-scan ultrasonography. RESULTS: By about 30 days post-PRK, the experimentally induced refractive errors was stabilized and the treated eyes were between +0.75 and +2.25 D more hyperopic than their fellow eyes. Subsequently, 7 monkeys showed systematic reductions in the degree of anisometropia. Although some regression in corneal power occurred, the compensating refractive changes were primarily due to the differences in vitreous chamber growth (r = 0.74, P = 0.046). CONCLUSIONS: Vision-dependent mechanisms that are sensitive to refractive error are still active in adolescent primates and probably play a role in maintaining stable refractive errors in the two eyes. Consequently, conditions that result in consistent hyperopic defocus could potentially contribute to the development of juvenile onset myopia in children.

Animals↗
PubMed1998

Screening for amblyopia in preverbal children with photoscreening photographs. National Children's Eye Care Foundation Vision Screening Study Group.

OBJECTIVE: This study aimed to determine the ability of healthcare professionals and lay volunteers to grade photoscreening photographs. DESIGN: The study design was a cross-sectional study. PARTICIPANTS AND INTERVENTION: One hundred children 3 years of age or younger received a complete ophthalmologic examination and were photographed using the Medical Technology Innovations (MTI) photoscreener. Twenty-six children had normal examination results, and the remaining 74 children had conditions that are of interest for pediatric screening, including strabismus, refractive error, media opacities, and ptosis. Eighteen volunteers, including pediatric ophthalmologists, pediatricians, ophthalmic technicians, health department nurses, Prevention of Blindness Society personnel, and Lions Club volunteers, graded each of the 100 photoscreening photographs. MAIN OUTCOME MEASURES: Sensitivity and specificity of vision screening and of photograph grading were measured. RESULTS: Results from various graders yielded sensitivities ranging from 37% to 88% and specificities ranging from 40% to 88%. No single grader achieved sensitivity and specificity both greater than 70%. The grading of the manufacturer's representative had a sensitivity of 43% and a specificity of 85%. Sensitivity decreased to 31% for strabismus and 18% for refractive error when the correct type of strabismus or refractive error was required to be considered true-positives. Results were not positively correlated with the ophthalmologic knowledge of the participant. CONCLUSIONS: The wide variability in sensitivities and specificities among graders indicates inconsistent photograph interpretation skills or deficient screening guidelines or both. For off-axis photoscreening as implemented by the MTI system to become a useful vision-screening method, additional photograph interpretation skill transfer may be beneficial, although not necessarily sufficient.

Allied Health Personnel↗
PubMedDate not supplied

A comparative study for mesopic contrast sensitivity between photorefractive keratectomy and laser in situ keratomileusis.

BACKGROUND AND OBJECTIVE: To compare the effect on visual performance of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with mesopic contrast sensitivity. PATIENTS AND METHODS: Postoperative visual performance for 40 eyes undergoing PRK and 40 eyes undergoing LASIK was compared with mesopic contrast sensitivity at 1, 3, and 6 months postoperatively. Eyes were divided into two groups (< -6.0 D and > -6.25 D). Mesopic contrast sensitivity was performed with the patient's best-corrected visual acuity of 20/20 or better under photopic conditions. RESULTS: A significant decrease in mesopic contrast sensitivity from preoperative baseline was obtained at all spatial frequencies for the PRK and LASIK groups (P < .05). There was no statistically significant difference at 1 or 3 months postoperatively in both groups (P > .05). At 6 months postoperatively, LASIK significantly decreased mesopic contrast sensitivity more than PRK in myopia with a refractive error of less than -6.0 D, especially at the middle and high spatial frequencies of 6, 9, and 12 cycles per degree (P < .05). However, no statistically significant differences in mesopic contrast sensitivity between PRK and LASIK were found in myopia with a refractive error of greater than -6.25 D (P > .05). CONCLUSIONS: In broad-beam excimer laser refractive surgery, PRK seemed to have a more significant effect on mesopic contrast sensitivity than LASIK for myopia with a refractive error of less than -6.0 D at 6 months postoperatively.

Adult↗
PubMed2004

[Blood flow in eye arteries assessed by Doppler ultrasound in patients with myopia].

PURPOSE: To assess blood flow in eye arteries using ultrasounds in patients with myopia, and to correlate the blood flow with refractive error. MATERIAL AND METHODS: Doppler ultrasonography was performed in 38 patients, age 31-50 years old, with myopia ranging from -2.0 to -25.0 D. Control group consisted of age matched emmetropic patients. RESULTS: Statistically significant decrease of Vs correlated to the value of refractive error was shown. CONCLUSIONS: In myopic eyes blood flow decreases with the increase of the refractive error.

Adult↗
PubMed1998

Control of the myopic shift in modified Badal optometer.

Refractive error measurements made with the Badal optometer typically register more myopia than is actually present. In this paper we measured the influence of the image size on the endpoint of a Badal optometer's refractive error measurement. The optometer was modified with a camera's zoom lens in such a way that the retinal image size could be controlled. It was found that retinal image size is a major factor in controlling the subjective endpoint. When retinal image size is diminished rather than increased as the target approaches the subject, as is the case under normal circumstances, the perceived endpoint more closely agrees with the actual refractive error.

Analysis of Variance↗
PubMed2004

Ocular axial length in homocystinuria patients with and without ocular changes: effects of early treatment and biochemical control.

PURPOSE: To establish whether myopia in homocystinuria could be due to increased ocular axial length. METHODS: Measurement of ocular axial length by A-scan ultrasound in eyes of homocystinuria patients. RESULTS: Patients were divided into three groups. Group I, with no ocular pathology (28 eyes), had mean refractive error of -0.25 D (spherical equivalent) and mean axial length of 23.4 mm +/- 0.9 (+/-1 standard deviation) mm. Group II, with phacodonesis or lens subluxation (12 eyes), had mean refractive error of -10.7 D and mean axial length of 23.8 mm +/-1.9 mm. Patients with phacodonesis had simple myopia whereas those with lens subluxation had marked myopic astigmatism. Group III included patients with complete lens dislocation in at least one eye (12 eyes) and were optically aphakic with a mean refractive error of +12.9 D and mean axial length of 24.9 mm +/- 0.9 mm. All Group I patients had good long-term metabolic control while those in Groups II and III did not. Group III eyes had significantly longer mean axial length than Group I (P =.0018) or normal eyes (P =.0163). There was no statistical difference in mean axial length between Group I and normal eyes. CONCLUSIONS: Ocular axial length is significantly increased in individuals with homocystinuria and lens dislocation. Increased axial length is a complication that has not been previously described in homocystinuria and may be preventable with early treatment and good biochemical control.

Adolescent↗
PubMed2003

Incidence and associations of retreatment after LASIK.

PURPOSE: To determine the incidence and risk factors for laser in situ keratomileusis (LASIK) retreatment and to present a novel retreatment technique. DESIGN: Retrospective noncomparative consecutive case series. PARTICIPANTS: Two thousand four hundred eighty-five eyes (1306 patients) underwent LASIK surgery for myopia, hyperopia, or astigmatism using either the Summit Apex Plus or the Alcon LADARVision excimer laser systems. Only retreatments for residual refractive error were included. MAIN OUTCOME MEASURES: Prevalence and incidence of retreatments were determined. Potential risk factors for retreatment, including age, gender, and attempted correction, were assessed. Refractive error and a ratio of residual sphere to cylinder in retreated eyes were also analyzed. RESULTS: Of the total cohort studied, 288 eyes of 233 patients underwent one retreatment, and 3 eyes of 3 patients required two retreatment procedures. The overall 1-year incidence of retreatment was 10.5%. The average length of time between initial treatment and enhancement was 7.3 +/- 6.4 months; 85% of retreatments took place within 1 year. Two hundred eighty-five of the 288 retreatments were accomplished using a manual flap lift approach; 3 eyes required a repeat microkeratome cut. Higher initial corrections and residual astigmatism were associated with a significantly higher rate of retreatment. Patients older than 40 years were at greater risk for retreatment. There was no gender difference. CONCLUSIONS: Higher initial corrections, astigmatism, and older age are risk factors for LASIK retreatment. Most LASIK flaps can be lifted using the manual technique described up to 3 years after initial surgery.

Adolescent↗
PubMedDate not supplied

Excimer laser photorefractive keratectomy for myopia: results in 1165 eyes. Italian Study Group.

BACKGROUND: We report the results of a prospective study conducted in Italy to evaluate the efficacy, safety, predictability, and complications of excimer laser photorefractive keratectomy for the correction of myopia. METHODS. Photorefractive keratectomy was performed on 1236 myopic sighted eyes in 16 centers, using the Summit Excimed 193 nm excimer laser. The attempted correction ranged from -0.80 to -25.00 diopters (mean, -7.83 +/- 3.88 D). The population was divided into three groups of attempted correction: between -0.80 and -6.00 D, between -6.10 and -9.90 D, and between -10.00 and -25.00 D. We report the data of 1165 eyes at 1 month, 970 eyes at 3 months, 752 at 6 months, and 330 at 12 months. At each visit, we evaluated (1) the refractive changes over time; (2) the difference between attempted and achieved correction; (3) uncorrected and best spectacle corrected visual acuity; and (4) haze. RESULTS: Twelve months after surgery, the spherical equivalent refractive error in 146 eyes with attempted correction of -0.80 to -6.00 D was -0.52 +/- 1.04 D; 104 eyes (71.2%) were within +/- 1.00 D of attempted correction. In 145 eyes with attempted correction of -6.10 to -9.90 D, the spherical equivalent refractive error was -1.66 +/- 1.88 D; 50 eyes (34.5%) were within +/- 1.00 D of attempted correction. The spherical equivalent refractive error in 39 eyes with attempted correction of -10.00 to -25.00 D was -1.86 +/- 3.47 D; 11 eyes (28.2%) were within +/- 1.00 D of attempted correction. Eight eyes (2.4%) lost two or more Snellen lines of best spectacle corrected visual acuity. None of the treatments caused severe postoperative complications, or scarring. CONCLUSIONS: Photorefractive keratectomy proved safe and effective, but highly predictable only in the correction of myopia up to -6.00 D.

Adolescent↗
PubMed2004

Automated lamellar therapeutic keratoplasty for post-PRK corneal scarring and thinning.

PURPOSE: To present the use of automated lamellar therapeutic keratoplasty (ALTK) for the treatment of post-photorefractive keratectomy (PRK) corneal scarring and thinning with significant residual myopia. DESIGN: Interventional case report. METHODS: A patient with high myopia of -12 diopters previously underwent PRK that resulted in corneal scarring, myopic regression, moderate loss of best-corrected visual acuity, a residual refractive error of -6.50/-1.00 x 175 degrees, and a remaining corneal thickness of 300 mum. ALTK was first performed to remove the scar and to augment corneal thickness, and a subsequent laser-assisted in-situ keratomileusis (LASIK) procedure was performed to correct the residual myopia. RESULTS: ALTK effectively removed the corneal scar and augmented the corneal thickness to 639 mum. LASIK effectively treated the residual myopia, resulting in an unaided visual acuity of 20/25 and a stable refractive error of plano/-0.50 x 40 degrees. The ALTK interface remained clear throughout the follow-up period of 26 months. CONCLUSION: ALTK may be a reasonable alternative to conventional penetrating keratoplasty in the treatment of post-PRK corneal scarring and thinning, with a moderate loss of best-corrected visual acuity, and LASIK can be subsequently performed to correct the residual refractive error and achieve an excellent refractive and visual outcome.

Adult↗
PubMed2001

[Comparison of visual function in myopia over -6.0 dpt after photorefractive keratectomy and laser in situ keratomileusis].

1. 41 myopes undergoing PRK and 31 patients undergoing LASIK for correction of spherical refractive error were examined before and 1, 3, 6 a 12 months after surgery on Schwind Multiscan with ablation zone between 5 and 7 mm. Mean preoperative spherical equivalent of refraction was -8.0 +/- 1.7 D in PRK group and -9.2 +/- 2.1 D in LASIK one. 2. Contrast sensitivity (CS) was tested on a computerized system of the Contrast sensitivity 8010 type in 6 spatial frequencies (0.74; 1.97; 3.69; 7.39; 14.77; 29.55 c/deg) and the best corrected visual acuity (BCVA) was measured on the normalized charts with Landolt rings. 3. At 12 months postoperatively, mean spherical equivalent of refraction was -0.6 +/- 1.0 D (PRK) and -1.0 +/- 0.8 D (LASIK). A refractive error within +/- 0.5 D had 31.5% (PRK) and 57.5% (LASIK) patients. Increasing of BCVA was measured in 51.5% (PRK) and 41.9% (LASIK) patients about 1 optotype to 2.5 lines. Mean CS in 6 frequencies reached 99.4; 102; 105; 109; 115 and 140% of preoperative values in PRK group and only 96; 95.8; 96.3; 95.8; 97.8 and 94.6% in LASIK one. 4. At 12 months after surgery, mean spherical equivalent, CS was better and number of patients with increased BCVA was significantly higher after PRK, than those attained with LASIK. On the other hand, a number of patients with a refractive error within +/- 0.5 D was higher and percentage of reoperations was lower in LASIK group.

Adolescent↗
PubMed2006

The Nepal Longitudinal Study: biometric characteristics of developing eyes.

PURPOSE: To identify differences in potential biometric markers for predicting refractive error in school children. METHODS: Biometric data on 895 Tibetan children, aged 6 to 18 years, residing in Katmandu, Nepal, were collected biennially from 1992 to 2000. Measurements included cycloplegic autorefraction, A-scan ultrasonography, and video phakometry. Only those children who had been studied at least once at age 12 years or more were included in the analysis. Subjects were divided into two groups: a myopia group if the refractive error was myopic by more than -0.50 D and a nonmyopia group if the refractive error was maximally myopic by -0.50 D, expressed as a spherical equivalent error in the left eye. RESULTS: Biometric measures that differed significantly with increasing age between the two refractive groups included: anterior chamber depth + 0.012 mm/year (p = 0.014), anterior lens radius of curvature + 0.073 mm/year (p = 0.001), lens power -0.059 D/year (p = 0.082), lens thickness -0.005 mm/year (p = 0.02), and vitreous chamber depth + 0.084 mm/year (p < 0.001). Corneal radii of curvature of the myopic group were steeper at all ages by 0.09 mm (p < 0.001), but the rate of change with age was equivalent across the refractive groups. CONCLUSIONS: Compared with those who remained nonmyopic, children who developed myopia had a crystalline lens that was initially thicker and steeper, and a vitreous chamber that was initially shorter. With age, children who became myopic developed greater lens thinning, greater flattening of the anterior lens surface radius, and a greater increase in vitreous chamber depth than their nonmyopic counterparts.

Adolescent↗
PubMedDate not supplied

Results of laser in situ keratomileusis for myopia of -10 to -19 diopters with a Technolas 217 laser.

PURPOSE: To evaluate the effectiveness, predictability, and safety of laser in situ keratomileusis (LASIK) for correcting myopia greater than -10.00 D. METHODS: Sixty-five eyes of 37 patients with myopia greater than -10.00 D underwent LASIK. Patients were evaluated on day 1, 1 week, 1, 3, and 6 months after surgery. Parameters evaluated were uncorrected visual acuity (UCVA) and best spectacle-corrected visual acuity (BSCVA), residual refractive error, regression of correction, and presence of any complication. RESULTS: Mean preoperative BSCVA was 0.745 +/- 0.234, which improved to 0.8070 +/- 0.237 postoperatively. The average preoperative UCVA was 0.022 +/- 0.02; postoperative UCVA at 6 months was 0.536 +/- 0.255. UCVA of 20/40 or better was achieved in 58% (38 eyes) and 20/20 or better in 26% (17 eyes). The average refractive error before LASIK was -12.64 +/- 2.16 D (range -10.00 to -19.00 D). Mean residual refractive error 1 week following LASIK was -0.63 +/- 1.36 D, which regressed to a mean -1.78 +/- 2.08 D at the end of 6 months. Nineteen eyes (29%) were within +/-0.50 D of intended refractive correction. CONCLUSION: LASIK was partially effective in the correction of high myopia. An initial overcorrection may be programmed to offset the effect of refractive regression.

Adult↗
PubMed2000

[Unilateral amblyopia without strabismus and with anisometropia].

PURPOSE OF THE STUDY: To evaluate a group of patients with unilateral isometropic amblyopia according to presence of possible amblyogenic factors. MATERIAL AND METHODS: 37 patients (18 girls and 19 boys) with unilateral amblyopia without strabismus and with anisometropia of less than 1 D in any of the meridians were analysed according to such possible risk factors of amblyopia as age of examination, age of mother on delivery, sex, family history, puerperal complications, birth weight, refraction error, left or right eye. Depth of amblyopia, state of binocular vision and results of optical and pleoptical treatment were also evaluated. RESULTS AND DISCUSSION: No significant risks were found regarding the age of patient, sex, left or right eye, birth weight, age of mother on delivery, puerperal complications and family history. Refraction error was not high. Depth of amblyopia did not correlate with amount of refraction error. Central fixation was present only in 50% and stereopsis only in 42% of patients. 10 patients revealed no significant defect of fixation or binocular vision. All patients responded significantly poorly to treatment. CONCLUSIONS: Presence of amblyopia in patients with isometropia cannot be explained by genetic or puerperal risk factors. It might have developed in the period sensitive for amblyopia as a result of anisometropia that was later diminished by the process of emmetropisation or microstrabismus which was spontaneously cured. Some cases can be described as idiopathic because no defect can be detected. Early in life screening is necessary to successfully diagnose and treat amblyopia in childhood.

Amblyopia↗