1. P.S.Selvakumar Faculty Aravind School of Optometry
ANISOMETROPIA
P.S.Selvakumar
Faculty
Aravind School of Optometry

2. Definition
A condition in which the refractive error is unequal between two eyes
A difference of more than 1.0D is clinically significant.

3. Causes Hypermetropic in childhood Myopic in adolescence
Unilateral cataract surgery
Some corneal diseases
Congenital being difference in axial length

4. Types Low : < 2.00D Moderate : between 2.0 D and 3.0D
High : >3.0D

5. Refractive types
Compound astigmatic anisometropia- both eye are astigmatic having difference of more than 1D error
Compound hyperopic-both eye are hyperopic having difference of more than 1D error
Compound myopic- both eye are having myopic difference of more than 1D error
Antimetropia – one eye myopic and one eye hyperopic
Simple astigmatic- one eye only astigmatic
Simple myopic-one eye only myopic
Simple hypermetropic-one eye only hyperopic

6. Sign and Symptoms Blurred vision Asthenopia Headache
Uneasiness / Heaviness with glass.
Diplopia
Binocular discomfort vision.

7. Assessment Visual acuity Accurate monocular refraction.
Binocular vision test
Binocular balance test.
Cycloplegic refraction

8. Treatment
Spectacle.
Contact lens usually for high degree of anisometropia.
Refractive surgery.

9. Problems in anisometropia
Squint:
convergence squint in child
divergence squint in adult
Diplopia
Amblyopia
Suppression of Binocular vision

10. AMBLYOPIA

11. Definition
A condition of visual loss without any apparent disease of the eye.
Laziness of the eye

12. Causes Uncorrected refractive error Squint Corneal opacity
Unilateral cataract
Ptosis
Suppression of blurred image

13. Types Congenital amblyopia:- Since birth one is not using vision
Acquired amblyopia
Ametropic amblyopia:- one eye is high ametropic having less vision which form blurred image so brain suppress it causing amblyopia
Strabismic amblyopia:-image formed by eye with squint in place other than fovea so brain suppress it causing amblyopia
Anisometropic amblyopia: if difference is high, eye with high refractive error is suppressed Stimulation deprivation amblyopia: amblyopia due to not using an eye for vision

14. Symptoms Frequent squinting or closing one eye to see
Poor visual acuity
Eyestrain
Headaches
Eyes do not move together or fix on the same point
Crying or complaining of an eye when one eye is covered
Cloudiness in the pupil (cataract)

15. Treatment
Most effective when done early in the child's life, usually before age seven.
It is important that any anisometropia and refractive problems be treated initially
Occlusion therapy:
Patching
Atropine(for uncooperative children )

16. Thankyou