A Unilateral Myopic Shift Secondary to Sturge-Weber Syndrome Results in Refractive Amblyopia of the Fellow Eye in a Pediatric Patient

Authors

McKenzie Stewart, Children's Mercy Kansas CityFollow
Christina Twardowski, Children's Mercy Kansas CityFollow

Publication Date

11-2024

Files

Abstract

A 4-year-old patient with unilateral glaucoma secondary to Sturge-Weber Syndrome causes a myopic shift. The fellow healthy eye maintains high hyperopia resulting in anisometropic refractive amblyopia, requiring occlusion therapy. It is well documented that a glaucomatous high IOP causes an expansion of the globe due to excessive plasticity of collagen fibers in pediatric eyes. The elongated axial length induces myopic shifts. In this patient, the myopic shift in her glaucomatous eye resulted in a unilateral high hyperopic refractive error in the fellow eye with normal ocular health. This anisometropia is enough to cause amblyopia in the hyperopic eye. In past appointments, the patient demonstrated equal visual fixation with the 10BD prism test. Since equal fixation was previously found, no amblyopia therapy was initiated. Now that the patient can verbalize optotype acuity, a moderate amount of amblyopia was found warranting additional treatment. The mainstay treatment for moderate unilateral amblyopia is patching therapy or atropine penalization. As the patient has already been in the correct optical correction since 11 months of age, it can be assumed she has reached her maximum vision improvement from spectacles alone. The glasses prescription has been monitored closely since the initial visit and has remained stable. Based on the patient’s refractive error, depth of amblyopia, and family’s preferences, patching the left eye 2 hours a day was initiated. In this case, the eye without the initial pathology developed an amblyogenic reduction in visual acuity. With the lifelong risk of glaucomatous vision loss, it is important to maximize visual potential in the healthy eye of our patient while they are still in their vision development period. In the setting of ocular pathology in pediatric patients, it is important to understand the secondary impacts that could occur during the vision development period.

Disciplines

Ophthalmology

Notes

Presented at the 2024 American Academy of Optometry Meeting; Indianapolis, Indiana; November 6-9, 2024.

Recommended Citation

Stewart, McKenzie and Twardowski, Christina, "A Unilateral Myopic Shift Secondary to Sturge-Weber Syndrome Results in Refractive Amblyopia of the Fellow Eye in a Pediatric Patient" (2024). Posters. 430.
https://scholarlyexchange.childrensmercy.org/posters/430