Purpose: To demonstrate the refractive changes of amblyopic children attributed to high anisometropia in the myopia endemic in Taiwan. Methods: Amblyopic children younger than 10 years with myopic or hyperopic anisometropia 3 diopters (D) or more who had follow-up for more than 2 years and had final visual acuity of 20/30 or better in the amblyopic eye were included. Results: The average age on the first visit was similar for the 13 myopic children (5.5 years) and 17 hyperopic children (5.3 years). Initially, the mean anisometropia was significantly different (myopic, 7.25 D vs. hyperopic, 3.89 D), but the visual acuity of the amblyopic eye (logarithm of the minimum angle of resolution) was similar between both groups at baseline (0.50 vs. 0.57). Myopization of the sound eye surpassed that of the amblyopic eye in the myopic group, which resulted in a yearly reduction of anisometropia of 0.51 D. However, hyperopia decreased synchronously in both eyes of the hyperopic children. The final degree of anisometropia was not significantly different between the two groups (4.07 D vs. 3.62 D). Conclusions: Growing up in a country with a high prevalence of myopia, children with myopic and hyperopic anisometropia in this study inevitably had myopization in both eyes. Myopic anisometropia decreases significantly over time, but hyperopic anisometropia remains constant.
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