Prevalence of Anisometropia in Infants and Young Children: The Multi-Ethnic Pediatric Eye Disease Study

Abstract

Purpose: : To determine age- and ethnicity-related anisometropia prevalence in 6-72 month old Hispanic and African-American children.

Methods: : A population-based cohort of 6- to 72-month-old children underwent Retinomax autorefraction 30-60 minutes after cycloplegia with 1% cyclopentolate (0.5% if ≤12 months). Retinoscopy was performed if autorefraction was unsuccessful. Noncycloplegic retinoscopy was performed if drops were refused. The prevalence of anisometropia by spherical equivalent (SE) and by difference in plus cylinder in any axis (cylindrical) was determined for age, gender and ethnicity.

Results: : 3024 Hispanic and 2993 African-American children were tested. Overall the prevalence of SE anisometropia ≥1.0D was 4.0% for Hispanics; 4.2% for African Americans. Prevalence of SE anisometropia ≥3.0D was 0.1% for Hispanics; 0.3% for African Americans. Prevalence of cylindrical anisometropia ≥1.0D was 5.4% and 4.5%, respectively. Cylindrical anisometropia ≥3.0D was 0.1% and 0%, respectively. SE anisometropia decreased with age in Hispanics (p=0.01 trend test) but not African Americans (p=0.5). Cylindrical anisometropia decreased with age in both ethnic groups (p=.003 and 0.0003). There was no significant difference in anisometropia between ethnic groups after adjusting for age (p=0.77 for SE; 0.10 for cylindrical). Anisometropia did not vary by gender.

Conclusions: : Cylindrical and/or SE anisometropia (≥1.0D) affects 5-10% of Hispanic and African-American preschoolers. Anisometropia ≥3.0D is rare. SE anisometropia decreases in prevalence with age in Hispanics, but not in African-Americans suggesting a possible genetic role in interocular refractive disparity.

Keywords: refractive error development • clinical (human) or epidemiologic studies: prevalence/incidence