Anisometropia can lead to monocular deviation if the refractive error is not corrected. Therefore, the authors evaluated the change in angle deviation after visual acuity improvement by refractive correction in monocular deviated patients with anisometropia.

Changes in angle deviation were collated retrospectively for 9 patients with anisometric monocular deviation, 7 with monocular exotropia and 2 with monocular esotropia, according to medical records. The patients were admitted for strabismus surgery performed using cataract extraction or clear lens extraction (8 patients) or were treated nonsurgically using contact lenses for visual acuity recovery (1 patient).

Prior to corrective measures, patients with exotropia had, on average, exodeviation of 40.43 PD, and those with esotropia had, on average, esodeviation of 27.50 PD. After corrective measures were taken, all 7 exotropia patients had decreased angle deviation, and, upon final evaluation, exodeviation had decreased to 21.71 PD, on average. In two exotropia patients, measures taken to correct refractive error shifted the exotropia to exophoria. There was no change in angle deviation after Corrective measures in 2 esotropia patients.

In cases of exotropia caused by decreased visual acuity, correction of the visual acuity should be performed first if the correction is possible. After the recovery of visual acuity, a significant decrease in angle deviation occurs.