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Anisometropia

Anisometropia occurs when eyes have unequal focusing because two eyes have different refractive power. The word comes from two Latin words – aniso = different and metropia = measure. This typically occurs because there is asymmetry present in the eyes. The difference between the eyes usually causes blurry vision and viewing of objects unequally. For example, in one eye an object may appear smaller than it appears in the other eye. The general vision in unequal and disproportionate in some structural fashion. Although this condition can be present at birth, it is often not diagnosed until sometime during childhood.

Symptoms&causes Treatment Author

What Is Anisometropia?

Here is an interesting fact. Just like everything in medicine, one condition can give rise to quite a few diagnostic names. So, the same situation happens here. If you have anisometropia, there is a good chance you also have ametropia, which can have couple of other diagnosis (hyperopia, myopia or astigmatism). Naturally, such collection of names can confuse and scare anyone not working in ophthalmology. Ok, let’s make it simple and translate in the words we know.

Two eyes should normally have an identical vision, which means that they have same optics installed (well, by Nature of cause). Does it happen all the time? Not really. Most of us have some small differences in the size of the right and left body. For example, one hand has longer fingers, and one ear is slightly higher than another, and so on. Indeed, that can be true for your eyes. Only having two hands slightly different will affect which size of gloves you need, while the differences in the eye shape or size will impact how you see things and tell an optometrist which “size” of eyeglasses you need to correct the problem.

Now it gets easier. Ametropia means that you cannot see things clear far (myopia or nearsightedness) or you cannot see things close (hyperopia or farsightedness). Astigmatism is the name of condition when the image is not exactly in the center. While ametropia means both of your eyes are near- or far- sighted, anisometropia just means that one eye is more affected than another.

So, there is nothing to fear when you see or hear “anisometropia” after your eyes get examined. This is a difference in measurements that really tells you that one eye is most likely slightly smaller than another and may be not exactly round. Sometimes there is another diagnosis you might hear – strabismus. That means that the problem is due to eye alignment – crossed eyes is the common term people and some doctors will use.

Why does Anisometropia develop?

In fact, it is not known why anisometropia develop. As we discussed before, the most likely explanation is a discrepancy in size and shape of the eyeballs. So, the Nature is to blame.

Types of Anisometropia

Anisometropia is divided in types according to the difference in refractive power of the eyes. In a way, it is not very important for you which type of anisometropia you have. This is more important for the eye doctors and will tell them how to treat it. Myopic (nearsighted eyes) anisometropia of more than 2 D can cause a significant impairment of binocular vision.

Simple Anisometropia

Simple anisometropia occurs when one eye is affected but the other eye is not. The affected eye can be hyperopic (farsighted) or myopic (nearsighted). Because one eye is unequal and the other eye is aligned there will be visual disturbances such as blurry vision. The effects of simple anisometropia may be noticeable or may be slight in which case can go unnoticed for quite some time until pronounced visual changes occur.

Compound Anisometropia

With compound anisometropia there will be notable blurry vision that is more pronounced than in the other eye. This occurs when there is myopia in both eyes, but different refractive error. When refractive error is present, light does not bend correctly which results in blurry images and blurry visual perception.

Antimetropia (Mixed Anisometropia)

Mixed Anisometropia occurs when both eyes have equal refractive error, although on eye may by myopic and the other eye hyperopic. With mixed anisometropia, one eye will be able to see objects far away while the other eye will not be able to. The imbalance of the bilateral visual acuity leads to impaired vision.

Meridional Anisometropia

This type of anisometropia is caused by one eye having high astigmatism, or cylinder correction in one eye. The refractive error correction is worse along one meridian and the eyes will have different levels of astigmatism present. In this case, both eyes will have astigmatism but at varying degrees bilaterally.

Anisometropia causes

There are anatomical factors that can contribute to anisometropia. Two eyes that are significantly different sizes can cause anisometropia. In addition, if the eye has mild anisometropia it can become more pronounced as the affected eye becomes weaker and the brain the begins to favor the stronger eye. Unequal sizes of the eyes can be a result of a birth defect which would also cause anisometropia.

Signs and Symptoms of Anisometropia

Signs of anisometropia may include a lazy eye (Amblyopia), or noticing of one eye that is not aligned as the other due to insufficient information transmitted to the optic nerve. Poor alignment of the eyes may be noticed in both eyes, resulting in crossed eyes or Strabismus. In addition, many symptoms may originate from double vision. Double vision may cause headaches, nausea, eyestrain, photophobia, dizziness and tiredness. It is important to note that anisometropia may also go unnoticed is symptoms are mild. An indication that anisometropia is present is a significantly different prescription strength on one eye versus the other eye.

Diagnosis

This condition is often detected during childhood during a vision screening, in a pediatrician’s office or at school. Anisometropia can be detected during an eye exam. A red reflex test can initially determine with the eyes are structurally unequal. This result will present as a duller red reflex in the affected eye. Contrast sensitivity can also determine the affected eye, as decreased sensitivity will be noted in the eye with anisometropia. Visual acuity testing can determine this diagnosis as well, noting that acuity will be decreased and misalignment present in the affect eye with anisometropia.