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Association between esodeviation and primary open-angle glaucoma: the 2010–2011 Korea National Health and Nutrition Examination Survey
  1. Jin-soo Kim1,2,
  2. Young Kook Kim1,3,
  3. Yong Woo Kim1,3,
  4. Sung Uk Baek1,4,
  5. Ahnul Ha1,5,
  6. Jinho Lee1,6,
  7. Haeng-Jin Lee7,
  8. Dai Woo Kim8,
  9. Jin Wook Jeoung1,3,
  10. Seong-Joon Kim1,9,
  11. Ki Ho Park1,3
  1. 1 Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  2. 2 Department of Ophthalmology, Chungnam National University Sejong Hospital, Sejong, Korea (the Republic of)
  3. 3 Division of Glaucoma, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
  4. 4 Department of Ophthalmology, Hallym University Sacred Heart Hospital, Anyang, Korea (the Republic of)
  5. 5 Department of Ophthalmology, Jeju National University College of Medicine, Jeju, Korea (the Republic of)
  6. 6 Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Chuncheon, Korea (the Republic of)
  7. 7 Department of Ophthalmology, Chonbuk National University Hospital, Jeonju, Korea (the Republic of)
  8. 8 Department of Ophthalmology, Kyungpook National University Hospital, Daegu, Korea (the Republic of)
  9. 9 Division of Neuro-ophthalmology and Strabismus, Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea (the Republic of)
  1. Correspondence to Young Kook Kim, Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea; md092{at}


Background/Aims To evaluate the association between strabismus and primary open-angle glaucoma (POAG) in a representative Korean population.

Methods A total of 11 114 participants aged 20 years or older in the Korea National Health and Nutrition Examination Survey database for the years 2010 through 2011 were reviewed. A standardised protocol was used to interview every participant and to perform comprehensive ophthalmic examinations. Glaucoma diagnosis was based on fundus photography and frequency-doubling technology perimetry results, according to the International Society of Geographical and Epidemiological Ophthalmology criteria. Ocular alignment was evaluated using the alternate prism and cover test, and clinically significant horizontal strabismus was defined as exodeviation of ≥15 prism dioptres (PD) and esodeviation of ≥10 PD. Univariate and multivariate regression analyses were used to evaluate the potential risk factors for POAG.

Results In the Korean population, subjects with clinically significant esodeviation had a much higher prevalence of POAG (12.32%) than those without clinically significant esodeviation (3.14%, p=0.016). After adjusting for age and intraocular pressure, clinically significant esodeviation was independently associated with POAG (OR 7.61, p=0.002).

Conclusion Esodeviation was independently associated with POAG in the Korean population. This could be the result of, at least in part, ocular-adduction-induced greater strain on the temporal optic nerve head and peripapillary tissues, which makes eyes with esodeviation more vulnerable to POAG.

  • Glaucoma
  • Optic Nerve
  • Epidemiology

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  • Contributors Conception and design of the work: J-SK, YKK; Acquisition, analysis or interpretation of data for the work: YWK, SUB, AH, JL; Drafting the work: J-SK, H-JL; Revising the work: YKK, DWK, JWJ, S-JK, KHP. All authors have approved the version to be published and agreed to be accountable for all aspects of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open-access repository.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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