Objective To explore the risk factors for bilateral refractive asymmetry in children.Methods A retrospective analysis was conducted on the clinical data of 156 children who underwent visual acuity examination in the Department of Ophthalmology of the Affiliated Hospital of Jiangsu University from January 2020 to December 2022.The children were divided into a normal refraction group(82 cases)and a refractive asymmetry group(74 cases)according to the examination results.Data on gender,age,body mass index,sleep time,eye use time,reading distance,and family history of eye diseases were collected for both groups of children.Optical biometers and corneal topographers were used to measure visual test indexes,including intraocular pressure,corneal average refractive power,equivalent spherical diopter,axial length,pupil diameter,functional optical zone,spherical aberration,and comet aberration.The risk factors for bilateral refractive asymmetry in children were screened using a multivariate logistic regression model,and a column line chart prediction model was constructed to evaluate the fitting effect of the model.Results The children in the refractive asymmetry group had longer eye use time(P＜0.05)and a higher proportion of family history of eye diseases,as well as higher differences in intraocular pressure,refractive power,equivalent spherical diopter,axial length,and pupil diameter between both eyes,and higher-order aberrations than those in the normal refraction group(P＜0.05).However,the daily sleep time,reading distance,and functional optical zone were lower in the refractive asymmetry group than in the normal refraction group(P＜0.05).The multivariate logistic regression model showed that a family history of eye diseases[(OR)=13.523(95％CI:3.358,54.461)],sleep time[(OR)=0.064(95％CI:0.023,0.179)],eye use time[(OR)=21.424(95％CI:6.121,74.983)],reading distance[(OR)=0.087(95％CI:0.036,0.211)],intraocular pressure difference[(OR)=86.960(95％CI:14.687,514.897)],corneal refractive power difference[(OR)=1.736(95％CI:1.043,2.890)],equivalent spherical diopter difference[(OR)=12.937(95％CI:4.300,38.925)],axial length difference[(OR)=29.077(95％CI:10.166,83.170)],pupil diameter difference[(OR)=14.179(95％CI:4.880,41.198)],functional optical zone difference[(OR)=0.495(95％CI:0.291,0.844)],spherical aberration[(OR)=68.843(95％CI:16.304,290.687)],and comet aberration[(OR)=2.085(95％CI:1.007,4.318)]were all risk factors for bilateral refractive asymmetry in children(P＜0.05).Conclusion Children's eye habits and eye examination indicators are important factors affecting bilateral refractive asymmetry.Intervention measures can be taken in a timely manner to prevent children from developing refractive abnormalities.
refractive asymmetrynomogramaverage corneal refractive power of the anterior surfaceequivalent spherical dioptermultivariate analysis
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