It has long been reported that nuclear sclerosis is associated with the development of myopia, and many modern population studies find large refractive changes caused by lens changes but there are also studies that disagree.4,6,17
The middle panels show examples where each eye has the same lens code and the refraction changed in the hyperopic direction in one eye while the other eye remained stable. For example, subject 511 (middle right) had significant anisometropia of 1.75 D at the first visit, which increased to 3.25 D at the second visit. Clearly, myopia induced by lenticular sclerosis is not the reason for the significant anisometropia in this case because the lens code is the same in each eye. The bottom panels of Fig. 6 show two participants with no discernable lens changes who also developed significant anisometropia.
Individual analysis of the refractive changes and the lens scores indicated that unequal development of nuclear sclerosis in the two eyes could explain the spherical error anisometropia in about 40% of subjects who developed 1 D or more of anisometropia; but in the remaining subjects, other factors must be responsible for these changes in the spherical error. When spherical equivalent is used, many people developed anisometropia from changes in the power and/or axis of the cylinder components.
It should be noted that no one in our study had a nuclear sclerosis score of more than 2.0, which means that their lenses were relatively clear and, in many other studies, they would not have been classified as having nuclear cataract.17,29,30
This study was supported by National Eye Institute, National Institutes of Health grant EY09588 to JAB and the Smith-Kettlewell Eye Research Institute.
Presented, in part, at the annual meeting of the Association for Research in Vision and Ophthalmology (ARVO), May 2011, Ft. Lauderdale, Florida.
Received March 21, 2013; accepted August 15, 2013.
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