Profile of binocular vision & accommodation dysfunction in myopic children at a tertiary eye hospital in north India

Purpose: To evaluate the profile and frequency of binocular vision & Accommodation dysfunction among myopic children attending the myopia clinic at a tertiary care eye hospital in North India. Methods: A cross-sectional, prospective study was conducted at the Myopia and Binocular Vision Therapy (BVT) Clinic of Dr. Shroff’s Charity Eye Hospital, New Delhi, from October 2023 to March 2024. A total of 543 children aged 6–18 years with myopia (spherical equivalent ≥ –0.50 D) were included. Binocular vision evaluation was performed using standard protocols including cover tests, NPC, NPA, fusional vergence amplitudes, accommodative facility, and MEM retinoscopy. BVDs were classified based on Scheiman and Wick criteria. Data were analyzed using SPSS v29, and statistical significance was set at p < 0.05. Results: Overall, 52.2% of children had at least one Binocular Vision Disorder. Convergence insufficiency (18.5%) and intermittent exotropia (16.3%) were the most common. Normal binocular function decreased significantly with increasing myopia severity (70.3% in mild vs. 29.7% in high myopia; p < 0.001). Poor convergence showed a moderate negative correlation with higher myopia (r = –0.32, p = 0.03). Accommodative insufficiency was rare and observed only in high myopia (2.7%). Conclusion: Binocular vision dysfunctions are highly prevalent among Indian children with moderate to high myopia, with convergence insufficiency and intermittent exotropia being the most significant. These findings underscore the importance of routine binocular vision screening and early intervention in pediatric myopia clinics.