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dc.contributor.authorBarrett, Brendan T.*
dc.contributor.authorBradley, A.*
dc.contributor.authorCandy, T.R.*
dc.date.accessioned2016-10-27T15:50:11Z
dc.date.available2016-10-27T15:50:11Z
dc.date.issued2013-09
dc.identifier.citationBarrett BT, Bradley A and Candy TR (2013) The relationship between anisometropia and amblyopia. Progress in Retinal and Eye Research. 36: 120-158.
dc.identifier.urihttp://hdl.handle.net/10454/10119
dc.descriptionNo
dc.description.abstractThis review aims to disentangle cause and effect in the relationship between anisometropia and amblyopia. Specifically, we examine the literature for evidence to support different possible developmental sequences that could ultimately lead to the presentation of both conditions. The prevalence of anisometropia is around 20% for an inter-ocular difference of 0.5D or greater in spherical equivalent refraction, falling to 2-3%, for an inter-ocular difference of 3D or above. Anisometropia prevalence is relatively high in the weeks following birth, in the teenage years coinciding with the onset of myopia and, most notably, in older adults starting after the onset of presbyopia. It has about one-third the prevalence of bilateral refractive errors of the same magnitude. Importantly, the prevalence of anisometropia is higher in highly ametropic groups, suggesting that emmetropization failures underlying ametropia and anisometropia may be similar. Amblyopia is present in 1-3% of humans and around one-half to two-thirds of amblyopes have anisometropia either alone or in combination with strabismus. The frequent co-existence of amblyopia and anisometropia at a child's first clinical examination promotes the belief that the anisometropia has caused the amblyopia, as has been demonstrated in animal models of the condition. In reviewing the human and monkey literature however it is clear that there are additional paths beyond this classic hypothesis to the co-occurrence of anisometropia and amblyopia. For example, after the emergence of amblyopia secondary to either deprivation or strabismus, anisometropia often follows. In cases of anisometropia with no apparent deprivation or strabismus, questions remain about the failure of the emmetropization mechanism that routinely eliminates infantile anisometropia. Also, the chronology of amblyopia development is poorly documented in cases of 'pure' anisometropic amblyopia. Although indirect, the therapeutic impact of refractive correction on anisometropic amblyopia provides strong support for the hypothesis that the anisometropia caused the amblyopia. Direct evidence for the aetiology of anisometropic amblyopia will require longitudinal tracking of at-risk infants, which poses numerous methodological and ethical challenges. However, if we are to prevent this condition, we must understand the factors that cause it to develop.
dc.relation.isreferencedbyhttp://dx.doi.org/10.1016/j.preteyeres.2013.05.001
dc.subjectAdolescent
dc.subject; Adult
dc.subject; Age factors
dc.subject; Amblyopia
dc.subject; Anisometropia
dc.subjectChild
dc.subject; Child
dc.subject; Humans
dc.subject; Infant
dc.subject; Prevalence
dc.subject; Refractive errors
dc.subject; Risk factors
dc.subject; Amblyopia
dc.subject; Anisometropia
dc.subject; Anisometropic amblyopia
dc.subject; Emmetropization
dc.subject; Refractive error
dc.subject; Visual development
dc.titleThe relationship between anisometropia and amblyopia
dc.status.refereedYes
dc.typeArticle
dc.type.versionNo full-text available in the repository


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