Comparing myopic error in patients with basic and convergence insufficiency intermittent exotropia in China

PURPOSE: To compare the degree of myopia between the dominant and non-dominant eyes in teenagers with intermittent exotropia (IXT) in China. METHODS: A total of 199 IXT patients with myopia were included in this retrospective study and were divided into two groups according to the difference between near and distance exodeviation: basic IXT and convergence insufficiency (CI) IXT. Refractive errors were analyzed by spherical equivalent (SE) values. Patients were further stratified into anisometropia group and non-anisometropia group based on binocular SE values difference greater than 1.0D or not. RESULTS: There were 127 patients in the CI IXT group, with a near deviation of 46.94 ± 20.53 prism diopters (PD) and a distance deviation of 28.36 ± 14.34 PD, and there were 72 (36.2%) patients in the basic IXT group, with a near deviation of 37.68 ± 22.21 PD and a distance deviation angle of 33.21 ± 23.96 PD. The near exodeviation was significantly larger in the CI group than in the basic IXT group(P < 0.001). In the CI IXT group, the mean SE was − 2.09 ± 1.45 diopters (D) in the dominant eye and − 2.53 ± 1.44D in the non-dominant eye, while in the basic IXT group, the mean SE was − 2.46 ± 1.56D in the dominant eye and − 2.89 ± 1.37D in the non-dominant eye. The anisometropia group included 43 patients, while non-anisometropia group included 156 patients. The near and distance exodeviation in the anisometropia group were 45.26 ± 24.41 PD and 33.53 ± 23.31 PD, respectively, and those in the non-anisometropia group were 43.42 ± 20.69 PD and 29.07 ± 16.84 PD, respectively. There were no significant differences in near and distance deviation (P = 0.78 and P = 0.73 respectively) between the two groups. The SE of the dominant eye was less myopic than of the non-dominant eyes in both the CI and anisometropia groups (P = 0.002 and P < 0.001, respectively). CONCLUSIONS: Our study revealed that convergence insufficiency IXT is more common than the basic type in pediatric myopic population and is characterized by higher inter-eye differences of myopia. The dominant eye was found to be less myopic in IXT patients, particularly in those with convergence insufficiency and anisometropia.