Case Report: Anisometropic Astigmatism Secondary to Unilateral Coronal Synostosis.

SIGNIFICANCE: This case highlights the importance of performing a cycloplegic examination, including retinoscopy, on infants with the diagnosis of craniosynostosis because of the risk of refractive amblyopia.

PURPOSE: This report presents the unique case of an infant with amblyogenic anisometropic astigmatism secondary to unilateral coronal synostosis, which resolved after fronto-orbital advancement.

CASE REPORT: A 4-month, 14-day-old male infant with right unilateral coronal synostosis associated with Pfeiffer syndrome presented to the clinic with anisometropic astigmatism (right eye, +2.00 diopter sphere; left eye, +4.00 -4.75 ×170). Because of his young age, this refractive error was initially monitored. Upon follow-up examination at 6 months of age, he showed stability in his refractive error and early signs of amblyopia. Glasses were prescribed and amblyopia resolved. After cranial surgery, the patient's orbits were symmetric, and his amblyogenic astigmatism resolved.

CONCLUSIONS

Patients who present to the clinic with craniosynostosis should undergo cycloplegic examinations, including retinoscopy, early in their care with the knowledge that these patients can require interventions such as glasses and amblyopia treatment.