Comparative Analysis of Refractive Error in Children with Unilateral and Bilateral congenital Nasolacrimal duct Obstruction

Abstract

Objectives: To determine and compare the frequency of various refractive errors in children with unilateral and bilateral congenial nasolacrimal duct obstruction.

Methodology: This comparative observational study was conducted at Al-Shifa Trust Eye Hospital, Rawalpindi from January-2025 to June-2025. A total of 220 children with congenital nasolacrimal duct obstruction (both unilateral and bilateral types) were included and were assessed for refractive errors. Comparison of refractive error types was performed using Chi-square test. Data was analyzed using SPSS version 22.

Results: Among 220 children, 160 (72.70%) patients had unilateral while 60 (27.30%) patients had bilateral disease. The median age was 5.00 (2.00) years. There were 139 (63.20%) male and 81 (36.80%) female patients. In patients with unilateral disease (n = 160), frequency of anisometropia was observed in 113 (70.63%) patients, while in patients with bilateral disease (n = 60), it was 5 (8.33%), (p < 0.001). In patients with unilateral disease (n = 160), most common type of refractive errors was myopia observed in 47 (29.38%) patients followed by hypermetropia in 44 (27.50%) patients and astigmatism in 24 (15.00%) patients while in patients with bilateral disease (n = 60), most common type of refractive errors was myopia observed in 13 (21.67%) patients followed by astigmatism in 7 (11.67%) patients and hypermetropia in 6 (10.00%) patients, (p = 0.001).

Conclusion: Refractive errors, particularly anisometropia, are much higher in patients with unilateral rather than bilateral congenital nasolacrimal duct obstruction.