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Successful Management of Pediatric High Anisometropia Using Traditional Treatment Methods: A Case Series

Correspondence: Requests for reprints should be addressed to: Aveen Banich, M.D., Dept. of Ophthalmology, Loyola University Medical Center, 2160 S. First Ave., Maywood, IL 60153.

Purpose: To report visual results in pediatric patients with high anisometropia following aggressive amblyopia treatment using traditional methods.

Methods: Charts of one physician, JM, were reviewed at a major university medical center for all patients with anisometropia of eight diopters or greater. Patients ranged from children with severe unilateral high myopia due to retinopathy of prematurity to one infant with severe microphthalmos, acoria, and congenital cataract. Four patients were identified. Final Snellen acuities were reported from the patient’s last clinic examination. Average follow-up period was four years.

Results: Final visual acuities of involved eyes ranged from line Snellen 20/60 to 20/20. One patient with severe microphthalmos, congenital acoria, congenital cataract, and anisometropia of 40 diopters achieved a final Snellen visual acuity of 20/40 OS. No patients developed visual loss in the normal eye due to patching. No patients were lost to follow-up.

Conclusion: Based on our observations, excellent visual outcomes may be achieved in pediatric patients with high anisometropia by aggressive use of conventional occlusion and refractive methods.

Key words: anisometropia, amblyopia, retinopathy of prematurity