Association of intraocular pressure and myopia in children

Abstract

Purpose: While elevated intraocular pressure (IOP) is associated with myopia in adults, its potential influence on the growth of eyes in juveniles without glaucoma is controversial. To address this issue, a possible relation between IOP and refraction in children was sought.

Methods: A cross-sectional survey of IOP was conducted in children presenting to the Division of Pediatric Ophthalmology at The Children's Hospital of Philadelphia for a complete eye examination. Measurement of IOP was attempted in all children, including those with amblyopia, prematurity, and strabismus. Exclusion criteria were abnormalities of the posterior pole and/or conditions such as cataract that precluded assessment of refractive error. For analysis, myopia was defined as a spherical equivalent of more than 1 diopter (D) of myopia. Logistic regression was used to assess the association between other patient characteristics and presence of myopia.

Results: Intraocular pressure testing was attempted in all age groups, but was more successful in older children. Reliable readings were obtained on 321 subjects. The mean age was 9.8 years, with a mean IOP of 17.3 mmHg in the right eye and 17.2 mmHg in the left and a mean spherical equivalent of +0.2 D in the right eye and +0.1 D in the left. Increasing age, a family history of myopia, and amblyopia were associated myopia. Increasing IOP also was related to myopia. Even when patients with amblyopia, strabismus, and prematurity were exclude, age, family history of myopia, and IOP again were associated with myopia.

Conclusions: These results indicate that IOP in children may be higher in myopic than nonmyopic eyes. Whether IOP could contribute to the mechanisms causing the abnormal eye growth of childhood myopia requires further study.