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—Dr Reifler questions the degree to which infants with dacryoceles may be at risk of anisometropic amblyopia. In our report, we observed that children with these lesions often have high cylindrical errors; the magnitude of astigmatism is comparable with that seen with hemangiomas. Because dacryoceles are usually unilateral and occur early in the critical period, we are concerned that affected patients may develop anisometropic amblyopia.In our experience, patients with dacryoceles are less likely to develop amblyopia than are patients with hemangiomas. Several factors may explain this finding. Unlike the hemangiomas, the dacryoceles in our series fortunately responded to early treatment. Both the dacryoceles and the astigmatism resolved within the patients' first six months of life. It may be that a "safe period" protects very young infants from developing amblyopia despite anisometropia. It may be that anisometropia must persist for many months before causing amblyopia at any time
Bogan S, Simon JW, Krohel G, Nelson L. Astigmatism Associated With Adnexal Masses in Infancy-Reply. Arch Ophthalmol. 1988;106(4):448. doi:10.1001/archopht.1988.01060130490010