ArticleTranslational vision science & technology2026
Interocular Comparison of Refractive Development in Children With Unilateral Traumatic Optic Neuropathy.
Article in Translational vision science & technology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: To characterize interocular refractive development in children with unilateral traumatic optic neuropathy (TON) and evaluate the effect of visual loss severity on myopia progression. Methods: This retrospective, longitudinal, self-controlled cohort included 21 children (18 boys) aged 3 to 15 years with unilateral TON, each having ≥2 cycloplegic spherical equivalent refractions (SERs) at least 6 months apart. Both eyes were analyzed, and TON eyes were stratified by baseline best-corrected visual acuity (BCVA) into no light perception (NLP) and better than NLP. Longitudinal SER trajectories were examined using linear mixed-effects models with subject-specific random intercepts and time slopes. Model 1 included Eye (TON versus fellow), Time (years since injury), Eye × Time, and baselineSER; model 2 additionally incorporated BCVA and interactions of Time with BCVA and baselineSER. Results: Mean age at injury was 11.29 ± 3.20 years, and mean follow-up was 2.94 ± 1.66 years. The Eye × Time coefficient was 0.250 D/y (95% confidence interval [CI], 0.170-0.330; P < 0.001), indicating significantly slower myopic progression in TON eyes. The Time × BCVA effect (0.195 D/y; 95% CI, 0.005-0.384; P = 0.044) indicated a flatter (less negative) myopic trajectory in NLP eyes. Conclusions: In pediatric unilateral TON, the injured eye shows markedly slowed and, in severe cases, nearly arrested myopic progression compared with the fellow eye, supporting a key modulatory role of postretinal visual input in refractive development. Translational Relevance: Unilateral TON provides a human model linking optic nerve integrity to refractive development and highlights the fellow eye as a high-risk target for myopia monitoring and control.
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