In studies of the genetic predisposition of refractive error, there is a correlation between environmental factors and the risk of developing myopia. Myopia has been observed in individuals with visually intensive occupations. Reading has also been found to be a predictor of myopia in children. It has been reported that children with myopia spent significantly more time reading than non-myopic children who spent more time playing outdoors. Socioeconomic status and higher levels of education have also been reported to be a risk factor for myopia.

A determination of the prevalence of anisometropia has several difficulties. First of all, the measurement of refractive error may vary from one measurement to the next. Secondly, different criteria have been employed to define anisometropia, and the boundary between anisometropia and isometropia depend on their definition.

Several studies have found that anisometropia occurs more frequently and tends to be more severe for persons with high ametropia, and that this is particularly true for myopes. Anisometropia follows a U-shape distribution according to age: it is frequent in infants aged only a few weeks, is more rare in young children, comparatively more frequent in teenagers and young adults, and more prevalent after presbyopia sets in, progressively increasing into old age.

One study estimated that 6% of those between the ages of 6 and 18 have anisometropia.

Notwithstanding research performed on the biomechanical, structural and optical characteristics of anisometropic eyes, the underlying reasons for anisometropia are still poorly understood.

Anisometropic persons who have strabismus are mostly far-sighted, and almost all of these have (or have had) esotropia. However, there are indications that anisometropia influences the long-term outcome of a surgical correction of an inward squint, and vice versa. More specifically, for patients with esotropia who undergo strabismus surgery, anisometropia may be one of the risk factors for developing consecutive exotropia and poor binocular function may be a risk factor for anisometropia to develop or increase.

According to an American study nearly three in 10 children (28.4%) between the ages of five and 17 have astigmatism. A recent Brazilian study found that 34% of the students in one city were astigmatic. Regarding the prevalence in adults, a recent study in Bangladesh found that nearly 1 in 3 (32.4%) of those over the age of 30 had astigmatism.

A Polish study published in 2005 revealed "with-the-rule astigmatism" may lead to the onset of myopia.

A number of studies have found the prevalence of astigmatism increases with age.

The yearly cost of correcting refractive errors is estimated at 3.9 to 7.2 billion dollars in the United States.

In one study, heredity was an important factor associated with juvenile myopia, with smaller contributions from more near work, higher school achievement, and less time in sports activity.

Long hours of exposure to daylight appears to be a protective factor. Lack of outdoor play could be linked to myopia.

Other personal characteristics, such as value systems, school achievements, time spent in reading for pleasure, language abilities, and time spent in sport activities all correlated to the occurrence of myopia in studies.

Some suggest that more time spent outdoors during childhood is effective for prevention.

Various methods have been employed in an attempt to decrease the progression of myopia, although studies show mixed results. Many myopia treatment studies have a number of design drawbacks: small numbers, lack of adequate control group, and failure to mask examiners from knowledge of treatments used.

Astigmatism is a type of refractive error in which the eye does not focus light evenly on the retina. This results in distorted or blurred vision at all distances. Other symptoms can include eyestrain, headaches, and trouble driving at night. If it occurs early in life it can result in amblyopia.

The cause of astigmatism is unclear. It is believed to be partly related to genetic factors. The underlying mechanism involves an irregular curvature of the cornea or abnormalities in the lens of the eye. Diagnosis is by an eye exam.

Three options exist for the treatment: glasses, contact lenses, and surgery. Glasses are the simplest. Contact lenses can provide a wider field of vision. Refractive surgery permanently changes the shape of the eye.

In Europe and Asia astigmatism affects between 30 and 60% of adults. People of all ages can be affected. Astigmatism was first reported by Thomas Young in 1801.

Many people with near-sightedness can read comfortably without eyeglasses or contact lenses even after age forty. However, their myopia does not disappear and the long-distance visual challenges remain. Myopes considering refractive surgery are advised that surgically correcting their nearsightedness may be a disadvantage after age forty, when the eyes become presbyopic and lose their ability to accommodate or change focus, because they will then need to use glasses for reading. Myopes with astigmatism find near vision better, though not perfect, without glasses or contact lenses when presbyopia sets in, but the more astigmatism, the poorer the uncorrected near vision.

A surgical technique offered is to create a "reading eye" and a "distance vision eye," a technique commonly used in contact lens practice, known as monovision. Monovision can be created with contact lenses, so candidates for this procedure can determine if they are prepared to have their corneas reshaped by surgery to cause this effect permanently.

Far-sightedness, also known as hyperopia, is a condition of the eye in which light is focused behind, instead of on, the retina. This results in close objects appearing blurry, while far objects may appear normal. As the condition worsens, objects at all distances may be blurry. Other symptoms may include headaches and eye strain. People may also experience accommodative dysfunction, binocular dysfunction, amblyopia, and strabismus.

The cause is an imperfection of the eyes. Often it occurs when the eyeball is too short, or the lens or cornea is misshapen. Risk factors include a family history of the condition, diabetes, certain medications, and tumors around the eye. It is a type of refractive error. Diagnosis is based on an eye exam.

Management can occur with eyeglasses, contact lenses, or surgery. Glasses are easiest while contact lenses can provide a wider field of vision. Surgery works by changing the shape of the cornea. Far-sightedness primarily affects young children, with rates of 8% at 6 years and 1% at 15 years. It then becomes more common again after the age of 40, affecting about half of people.

As hyperopia is the result of the visual image being focused behind the retina, it has two main causes:

- Low converging power of eye lens because of weak action of ciliary muscles

- Abnormal shape of the cornea

Far-sightedness is often present from birth, but children have a very flexible eye lens, which helps to compensate. In rare instances hyperopia can be due to diabetes, and problems with the blood vessels in the retina.

Six genes have been found to be associated with the condition. These genes include BANP-ZNF469, COL4A4, FOXO1, FNDC3B, IMMP2L and RXRA-COL5A1. Others likely also exist.

In the visual system, images captured by the eye are translated into electric signals that are transmitted to the brain where they are interpreted. As such, in order to overcome presbyopia, two main components of the visual system can be addressed: the optical system of the eye and the visual processing of the brain.

1. Image capturing in the eye – Solutions for presbyopia have advanced significantly in recent years, thanks to widened availability of optometry care as well as over-the-counter vision correction.

2. Image processing in the brain – Scientific solutions for overcoming the symptoms of presbyopia were developed in recent years and tested successfully in multiple studies. These solutions are available thanks to significant progress in the understanding of human brain plasticity and the field of perceptual learning.

Between 2 and 5% of the population in western countries have amblyopia. In the U.K., 90% of visual health appointments in the child are concerning amblyopia.

Depending on the chosen criterion for diagnosis, between 1 and 4% of the children have amblyopia.

Retinal image size is determined by many factors. The size and position of the object being viewed affects the characteristics of the light entering the system. Corrective lenses affect these characteristics and are used commonly to correct refractive error. The optics of the eye including its refractive power and axial length also play a major role in retinal image size.

Aniseikonia can occur naturally or be induced by the correction of a refractive error, usually anisometropia (having significantly different refractive errors between each eye) or antimetropia (being myopic (nearsighted) in one eye and hyperopic (farsighted) in the other.) Meridional aniseikonia occurs when these refractive differences only occur in one meridian (see astigmatism). Refractive surgery can cause aniseikonia in much the same way that it is caused by glasses and contacts.

One cause of significant anisometropia and subsequent aniseikonia has been aphakia. Aphakic patients do not have a crystalline lens. The crystalline lens is often removed because of opacities called cataracts. The absence of this lens left the patient highly hyperopic (farsighted) in that eye. For some patients the removal was only performed on one eye, resulting in the anisometropia / aniseikonia. Today, this is rarely a problem because when the lens is removed in cataract surgery, an intraocular lens, or IOL is left in its place.

Patients with keratoconus typically present initially with mild astigmatism and myopia, commonly at the onset of puberty, and are diagnosed by the late teenage years or early 20s. The disease can, however, present or progress at any age; in rare cases, keratoconus can present in children or not until later adulthood. A diagnosis of the disease at an early age may indicate a greater risk of severity in later life. Patients' vision will seem to fluctuate over a period of months, driving them to change lens prescriptions frequently, but as the condition worsens, contact lenses are required in the majority of cases. The course of the disorder can be quite variable, with some patients remaining stable for years or indefinitely, while others progress rapidly or experience occasional exacerbations over a long and otherwise steady course. Most commonly, keratoconus progresses for a period of 10 to 20 years before the course of the disease generally ceases in the third and fourth decades of life.

Aniseikonia is an ocular condition where there is a significant difference in the perceived size of images. It can occur as an overall difference between the two eyes, or as a difference in a particular meridian.

Anisometropia is the condition in which the two eyes have unequal refractive power. Each eye can be nearsighted (myopia), farsighted (hyperopia) or a combination of both, which is called antimetropia. Generally a difference in power of two diopters or more is the accepted threshold to label the condition anisometropia.

In certain types of anisometropia, the visual cortex of the brain will not use both eyes together (binocular vision), and will instead suppress the central vision of one of the eyes. If this occurs often enough during the first 10 years of life while the visual cortex is developing, it can result in amblyopia, a condition where even when correcting the refractive error properly, the person's vision in the affected eye is still not correctable to 20/20.

The name is from four Greek components: "an-" "not," "iso-" "same," "metr-" "measure," "ops" "eye."

An estimated 6% of subjects aged 6 to 18 have anisometropia.

Myopia, with or without astigmatism, is the most common eye condition in horses.

Several types of occlusion myopia have been recorded in tree shrews, macaques, cats and rats, deciphered from several animal-inducing myopia models. Preliminary laboratory investigations using retinoscopy of 240 dogs found myopic problems with varying degrees of refraction errors depending on the breed. In cases involving German Shepherds, Rottweilers and Miniature horses, the refraction errors were indicative of myopia. Nuclear sclerosis of the crystalline lens was noticed in older dogs.

Experiments into newborn macaque monkeys have revealed that surgically fusing the eyelid for one year results in eye deterioration as the eye has not had a chance to grow and develop. Keeping monkeys in the dark for a similar period, however, does not lead to myopia. In 1996, Maurice and Mushin conducted tests on rabbits by raising their body temperatures and intraocular pressures (IOP) and noted that while younger rabbits were prone to developing myopia, older rabbits were not. Some tests have revealed that myopia in some animals can be improved with eye drops containing zinc, by increasing the activity of superoxide dismutase (SOD).

The rhesus monkey's vision amplitude reduction is noticeable in its second decade of life; however the condition does not impede normal functioning. Older rhesus monkeys have more difficulty accommodating this reduction in vision amplitude, encountering difficulty in focussing on objects at close range, even objects on the ground within an arm's length.

Hypertropia may be either congenital or acquired, and misalignment is due to imbalance in extraocular muscle function. The superior rectus, inferior rectus, superior oblique, and inferior oblique muscles affect the vertical movement of the eyes. These muscles may be either paretic, restrictive (fibrosis) or overactive effect of the muscles. Congenital cases may have developmental abnormality due to abnormal muscle structure, usually muscle atrophy / hypertrophy or rarely, absence of the muscle and incorrect placement.

Specific & common causes include:

- Superior oblique Palsy / Congenital fourth nerve palsy

- Inferior oblique overaction

- Brown's syndrome

- Duane's retraction syndrome

- Double elevator palsy

- Fibrosis of rectus muscle in Graves Disease (most commonly inferior rectus is involved)

- Surgical trauma to the vertical muscles (e.g. during scleral buckling surgery or cataract surgery causing iatrogenic trauma to the vertical muscles).

Sudden onset hypertropia in a middle aged or elderly adult may be due to compression of the trochlear nerve and mass effect from a tumor, requiring urgent brain imaging using MRI to localise any space occupying lesion. It could also be due to infarction of blood vessels supplying the nerve, due to diabetes and atherosclerosis. In other instances it may be due to an abnormality of neuromuscular transmission, i.e., Myasthenia Gravis.

Strabismus can be seen in Down syndrome, Loeys-Dietz syndrome, cerebral palsy, and Edwards syndrome. The risk is increased among those with a family history of the condition.

Deprivation amblyopia (amblyopia ex anopsia) results when the ocular media become opaque, such as is the case with congenital cataract or corneal haziness. These opacities prevent adequate visual input from reaching the eye, and disrupt development. If not treated in a timely fashion, amblyopia may persist even after the cause of the opacity is removed. Sometimes, drooping of the eyelid (ptosis) or some other problem causes the upper eyelid to physically occlude a child's vision, which may cause amblyopia quickly. Occlusion amblyopia may be a complication of a hemangioma that blocks some or all of the eye. Other possible causes of deprivation and occlusion amblyopia include obstruction in the vitreous and aphakia. Deprivation amblyopia accounts for less than 3% of all individuals affected by amblyopia.

The eye, like any other optical system, suffers from a number of specific optical aberrations. The optical quality of the eye is limited by optical aberrations, diffraction and scatter. Correction of spherocylindrical refractive errors has been possible for nearly two centuries following Airy's development of methods to measure and correct ocular astigmatism. It has only recently become possible to measure the aberrations of the eye and with the advent of refractive surgery it might be possible to correct certain types of irregular astigmatism.

The appearance of visual complaints such as halos, glare and monocular diplopia after corneal refractive surgery has long been correlated with the induction of optical aberrations. Several mechanisms may explain the increase in the amount of higher-order aberrations with conventional eximer laser refractive procedures: a change in corneal shape toward oblateness or prolateness (after myopic and hyperopic ablations respectively), insufficient optical zone size and imperfect centration. These adverse effects are particularly noticeable when the pupil is large.

Quantitative comparisons between different eyes and conditions are usually made using RMS (root mean square). To measure RMS for each type of aberration involves squaring the difference between the aberration and mean value and averaging it across the pupil area. Different kinds of aberrations may have equal RMS across the pupil but have different effects on vision, therefore, RMS error is unrelated to visual performance. The majority of eyes have total RMS values less than 0.3 µm.

The most common method of classifying the shapes of aberration maps is to consider each map as the sum of fundamental shapes or basis functions. One popular set of basis functions are the Zernike polynomials. Each aberration may be positive or negative in value and induces predictable alterations in the image quality.

Because there is no limit to the number of terms that may be used by Zernike polynomials, vision scientists use the first 15 polynomials, based on the fact that they are enough to obtain a highly accurate description of the most common aberrations found in human eye. Among these the most important Zernike coefficients affecting visual quality are coma, spherical aberration, and trefoil.

Zernike polynomials are usually expressed in terms of polar coordinates (ρ,θ), where ρ is radial coordinate and θ is the angle. The advantage of expressing the aberrations in terms of these polynomials includes the fact that the polynomials are independent of one another. For each polynomial the mean value of the aberration across the pupil is zero and the value of the coefficient gives the RMS error for that particular aberration (i.e. the coefficients show the relative contribution of each Zernike mode to the total wavefront error in the eye). However these polynomials have the disadvantage that their coefficients are only valid for the particular pupil diameter they are determined for.

In each Zernike polynomial formula_1, the subscript n is the order of aberration, all the Zernike polynomials in which n=3 are called third-order aberrations and all the polynomials with n=4, fourth order aberrations and so on. formula_2 and formula_3 are usually called secondary Astigmatism and should not cause confusion. The superscript m is called the angular frequency and denotes the number of times the Wavefront pattern repeats itself.

List of Zernike modes and their common names:

Whereas the rhinoceros may suffer from less-than-adequate eyesight, it generally survives by concentrating with its superior hearing and sense of smell. Some reports, however state that it can see better when focusing with one eye, particularly when walking, posturing, and combatting.

It is the name given to the localised bulge in limbal area, lined by the root of the iris. It results due to ectasia of weak scar tissue formed at the limbus, following healing of a perforating injury or a peripheral corneal ulcer. There may be associated secondary angle closure glaucoma, may cause progression of the bulge if not treated. Defective vision occurs due to marked corneal astigmatism. Treatment consists of localised staphylectomy under heavy doses of oral steroids.