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Gunilla H. Portnoy, Lori A. Lott, Susan Hewlett, Marilyn E. Schneck, John A. Brabyn; Development and Progression of Anisometropia in the Elderly. Invest. Ophthalmol. Vis. Sci. 2011;52(14):2515. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the prevalence of anisometropia in older observers and to determine its longitudinal change.
The participants were a subset of the SKI study population-a longitudinal study of vision and aging. Subjective refractive error was collected from medical records the first time of testing. The refractive error was determined by the same examiner using subjective refraction at the 2nd test time. Only subjects with intact ocular lenses throughout the period in both eyes were included in the analysis. A total of 119 people were included. The average age at the first and 2nd test was 67.2 (sd 6.0) and 79.4 (sd 5.0) with of 12.2 years between tests on average.Anisometropia was calculated for equivalent sphere, sphere and primary astigmatism (with the rule or against the rule astigmatism). Very little oblique astigmatism was found at either time. Anisometropia was defined as a difference between the two eyes of at least 1D.
The table shows the distribution of anisometropia in the population.The percentage with anisometropia is quite high at the first test time (19% for equiv. sphere) and shows a significant increase at the second test time (40%). The prevalence increases by a factor of more than 2 for most refractive components. The levels of anisometropia of 1D or more are considerably higher than what is found in a pediatric population (~3%, Hirsch, 1967; Almader et al, 1990). Most of the change in anisometropia for sphere or equivalent sphere developed in people who did NOT have anisometropia the first time. Those with large amounts of anisometropia the first time tended to be more stable. There were no significant correlations between change in anisometropia and refractive error or amount of anisometropia the first time.
Anisometropia is much more common in older observers than in pediatric and young adult populations. The prevalence, incidence and amount of anisometropia for all refractive components increase significantly with increasing old age. Anisometropia in the elderly is a poorly recognized condition.
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