Clinical features and biometric profile of patients presenting with unilateral high myopia.

BACKGROUND: Unilateral myopia, though less common than bilateral myopia, presents unique clinical challenges. This study aimed to explore the prevalence and clinical characteristics of children presenting with unilateral myopia. METHODS: Children presenting with unilateral high myopia at a tertiary care center, with a cycloplegic spherical equivalent (SE) ≤ -5D in one eye and ≥ -3D in the other, between January 2022 and January 2023, were recruited. A comprehensive review of their birth records and ocular examination was undertaken. Ocular biometric parameters, including axial length (AL), keratometry (K), and lens thickness (LT), were measured by IOLMaster 700, and the progress of refractive error since diagnosis was noted. RESULTS: The study analyzed 25 patients with a mean age of 11.9 years (1-12 years) and a mean follow-up of 24.45 ± 2.4 months. Axial myopia was found in 84% of patients, and optic nerve abnormalities were present in 40%. There was associated amblyopia in 32%. The difference in the inter-eye AL, K, and LT was 0.85 ± 0.45 mm, 0.35 ± 0.20 D, and 0.12 ± 0.05 mm. Mean annual myopic progression in these eyes was 0.74 D (0.2-1.5 D). CONCLUSIONS: Unilateral myopia in a samples Indian population presents unique clinical characteristics. Unilateral axial myopia in a patient should prompt us to take a detailed birth history and look for optic nerve abnormalities. Amblyopia is seen in a significant proportion of unilateral myopes, and their myopic progression was 0.74D/year in our cohort.