Risk factors for anisometropia in schoolchildren: A population-based, longitudinal cohort study

Ophthalmic Physiol Opt. 2023 Nov;43(6):1500-1509. doi: 10.1111/opo.13215. Epub 2023 Aug 11.

Abstract

Purpose: To investigate the incidence rate and risk factors for anisometropia among young schoolchildren.

Methods: A population-based cohort study, the Myopia Investigation Study in Taipei, was conducted in primary schools in Taipei City. Children were recruited for biannual comprehensive eye examinations over 2 years. Cycloplegic autorefraction and slit lamp examinations were performed biannually. Data on demographic information, parental history, lifestyle and near-work activities were collected using parent-administered questionnaires at the first and final visits. Anisometropia was defined as ≥1 D difference in the spherical equivalent (SE) refractive error.

Results: A total of 7035 8-year-old children completed the 2-year follow-up evaluations. The average annual incidence of anisometropia was 3.8%. Multivariable logistic regression analysis revealed that baseline SE (odds ratio [OR]: 0.87 95% CI: 0.80-0.95) and female sex (OR: 1.24, 95% confidence interval [CI]: 1.02-1.50) were significantly associated with incident anisometropia. Among lifestyle risk factors, spending <1 h per day in after-school outdoor activities on weekdays (OR: 1.38, 95% CI: 1.08-1.76) and performing near work at a distance <30 cm (OR: 1.33, 95% CI: 1.08-1.64) were significantly associated with an increased risk of incident anisometropia. In the multiple linear regression analysis, the inter-eye difference in SE increased significantly in children performing near work at distances <30 cm (adjusted β = 0.03; p = 0.02).

Conclusions: This study indicated the annual incidence of anisometropia in Taiwanese schoolchildren. Less time spent outdoors and shorter eye-to-object distances during near work increased the risk of incident anisometropia.

Keywords: anisometropia; myopia; near work; refraction error.

MeSH terms

  • Anisometropia* / epidemiology
  • Child
  • Cohort Studies
  • Female
  • Humans
  • Longitudinal Studies
  • Myopia* / complications
  • Myopia* / epidemiology
  • Prevalence
  • Refraction, Ocular
  • Risk Factors