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Anisohypermetropia as a sign of unilateral glaucoma in the pediatric population

Authors Tan DKL, Teh GH, Ho CL, Quah BL

Received 15 February 2017

Accepted for publication 22 April 2017

Published 15 June 2017 Volume 2017:10 Pages 203—207

DOI https://doi.org/10.2147/IMCRJ.S134809

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Deborah KL Tan,1,2 Gillian H Teh,2,3 Ching Lin Ho,2,4 Boon Long Quah1,2

1Department of Paediatric Ophthalmology and Adult Strabismus, Singapore National Eye Centre, 2Singapore Eye Research Institute, 3Department of General Cataract and Comprehensive Ophthalmology, 4Department of Glaucoma, Singapore National Eye Centre, Singapore

Abstract: Childhood glaucoma poses a diagnostic and therapeutic challenge to ophthalmologists. Difficulty in examination and limitations on ability to perform structural and functional testing of optic nerve make diagnosis and verification of glaucoma control difficult in children. It is well known that an excessive loss of hyperopia is a useful sign in alerting the examining ophthalmologist to the possible diagnosis of glaucoma. We present an interesting case of juvenile onset glaucoma presenting with anisohypermetropic amblyopia in one eye and normal vision in the fellow eye that has glaucoma. It is an unusual case as the left eye with abnormal vision from hypermetropic amblyopia, though by itself requiring treatment, was a red herring for a potentially blinding condition in the fellow eye with normal vision and lower and less amblyogenic hyperopia on examination. We believe that glaucomatous enlargement of the right eye resulted in significant loss of hyperopia in that eye and in turn contributed to anisohypermetropic amblyopia in the left eye. To the best of our knowledge, this is the first reported case of juvenile onset glaucoma presenting with anisohypermetropic amblyopia in one eye and normal vision in the fellow eye that has glaucoma.

Keywords: childhood glaucoma, anisometropia, anisohypermetropia, amblyopia, myopic shift

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