Refractive Errors and Concomitant Strabismus in Children and Adolescents: A Hospital Based Observational Study

Abstract

Purpose: To study the different types of concomitant strabismus and associated refractive errors in children and adolescents. Material & Methods: In this observational study, 178 patients aged between 4-19 yrs with concomitant strabismus of ≥ 15 Prism Dioptre (PD) on prism bar cover test were included and examined by a strabismus expert for type and amount of deviation between July 2017 to June 2020 at a tertiary health care hospital in north India. Non-cycloplegic and cycloplegic refraction was performed by a trained optometrist. Glasses were prescribed to achieve the best corrected visual acuity (BCVA). Data collection was done using a predesigned and pretested questionnaire. Results: The mean age of the study population was 11.20 ± 5.49 years (Median: 10, range = 4-19 years) and 97 patients (55.5 %) were male and 81 (45.5%) were female. Seventy-five patients (42.13%) were esotropes, 87 (48.87%) were exotropes and 16 (8.99%) were in combined deviation group. Hypermetropia (83/140, 59.28%) was the most common type of refractive error among ametropes (140/178). Among the hypermetropes, 52 (62.7%) had esotropia and 25 (64.1%) of the myopes had exotropia. Further, 52 (69.3%) of the esotropes had hypermetropia but there was no such trend of error noticed among the exotropes (p value < 0.001, Chi-square test). There were 70 (39.32%) amblyopes in the study population, out of which 35 (50%) had esotropia (p value: 0.032, Chi-square test). Conclusion: Hypermetropia was the most common refractive error among the study population and hypermetropes were prone to have esotropia and vice-versa. Esotropia and hypermetropia were more common among amblyopes.

Keywords

• refractive error
• concomitant strabismus
• esotropia
• exotropia
• children
• adolescents
• amblyopia