Anisometropia and refractive status in children with unilateral congenital nasolacrimal duct obstruction

OBJECTIVE: The objective of the study was to evaluate the refractive status and thereby assess anisometropia in children with unilateral congenital nasolacrimal duct obstruction (CNLDO). STUDY DESIGN: This study design was a descriptive cross-sectional study. PLACE AND DURATION: this study was conducted at the Department of Pediatric Ophthalmology and Strabismology, Al-Shifa Trust Eye Hospital, Rawalpindi; from August 2013 to July 2014. METHODOLOGY: This study assessed consecutive children with unilateral CNLDO. Cycloplegic refraction on all children with CNLDO was performed followed by appropriate intervention. Refractive errors of the affected and normal eyes were compared. RESULTS: One hundred and twenty-four children with a mean age of 29.69 ± 21.12 months (range, 2 months to 8 years) were studied. Based on spherical equivalent (SE), hypermetropia was more common in the affected eyes (P < 0.001). Anisometropia of >1.5 diopters (D) was present in n = 17 (13.7%). Interocular difference was significant for spherical error and SE (P < 0.001) but not cylindrical errors. CONCLUSION: Unilateral CNLDO is associated with statistically significant anisometropia, especially anisohypermetropia which has amblyogenic potential. It is vital to perform cycloplegic refraction routinely and counsel parents regarding prognosis and regular follow-ups.