Effect of ocular alignment on emmetropization in children <10 years with amblyopia.

Purpose To determine whether change in refractive error is associated with ocular alignment in 105 children 3 to Design Prospective cohort study. Methods One hundred five children 3 to 8 Δ horizontal tropia). Multivariate regression models evaluated whether change in spherical equivalent refractive error was associated with alignment category, after adjusting for age, baseline spherical equivalent refractive error, and type of amblyopia treatment. Results Between enrollment and the age 10–year examination, there was a decrease in spherical equivalent refractive error from hyperopia to less hyperopia (amblyopic eye: −0.65 diopter, 95% CI −0.85, −0.46; fellow eye: −0.39 diopter, 95% CI −0.58, −0.20). A greater decrease in amblyopic eye refractive error was associated with better ocular alignment category ( P = .004), with the greatest decrease occurring in orthotropic patients. There was no relationship between ocular alignment category and change in fellow-eye refractive error. Conclusions Among children treated for anisometropic, strabismic, or combined mechanism amblyopia, there is a decrease in amblyopic eye spherical equivalent refractive error to less hyperopia after controlling for baseline refractive error. This negative shift toward emmetropia is associated with ocular alignment, which supports the suggestion that better motor and sensory fusion promote emmetropization.