Tackling amblyopia in human infants (original) (raw)
Related papers
The pattern of visual deficits in amblyopia
Journal of Vision, 2003
Amblyopia is usually defined as a deficit in optotype (Snellen) acuity with no detectable organic cause. We asked whether this visual abnormality is completely characterized by the deficit in optotype acuity, or whether it has distinct forms that are determined by the conditions ...
Ophthalmic and Physiological Optics, 2006
We examined the loss of letter contrast sensitivity (LCS) measured using the Pelli-Robson chart, and the extent to which any such loss was modulated by spectacle wear and occlusion therapy in children participating in an amblyopia treatment trial. Their initial mean interocular difference in logMAR acuity was approximately three times that of their LCS (0.45 vs 0.14 log units). Log LCS was weakly though significantly correlated with logMAR visual acuity (VA) for all VAs better than 0.90 (r ¼ )0.19, 95% CI: )0.28 to )0.10) whereas for all VAs of 0.90 or poorer, log LCS was markedly and significantly correlated with VA (r ¼ )0.72, 95% CI: )0.83 to )0.53). LCS in those children with a ‡0.1 log unit interocular difference on this test improved commensurately with VA during treatment. We conjecture that the spatial visual loss in all but the most severe amblyopes occurs in an area of resolution and contrast space that lies beyond that sampled by the Pelli-Robson chart.
Amblyopia : assessment and treatment of binocular visual function
2018
Unilateral amblyopia is a common neurodevelopmental syndrome characterized by reduced acuity and contrast sensitivity in the amblyopic eye (AE) & by abnormal inter-ocular visual function, e.g. reduced stereoacuity; without a concomitant etiological dysfunction. Standard treatment consists of a period of optical correction followed, when necessary, by occlusion therapy. Although ~70% children gain vision, this monocular therapy is limited by poor compliance and uncertain impact on stereo-function. Recently, binocular treatments have attempted to “rebalance” vision, by adjusting the intensity of monocular visual inputs (enhancing usage to AE or reducing fellow-eye -FE- one), while stimulating binocular cortical interactions. We have developed a “Balanced Binocular Viewing” (BBV) treatment that has patients spend an hour per day at home watching modified movies while wearing 3D goggles (to control what each eye sees). Movies present a blurred image to the FE and a sharp image to the AE...
The incidence and prevalence of amblyopia detected in childhood
Public health, 1991
We present incidence estimates for amblyopia using data from a study of a cohort of 364 children from a single English county who were referred during 1983 for occlusion therapy. Using a criterion of a visual acuity of 6/12 or worse to define amblyopia, we estimate that 3.0% of the county's children develop the condition. Successful treatment of some of these children means that 1.9% will remain amblyopic as adults.
A pragmatic approach to amblyopia diagnosis: evidence into practice
Clinical and Experimental Optometry
Amblyopia is a common cause of reduced vision in children. The clinical diagnosis is complicated and requires consideration of the severity of vision loss relative to the characteristics of the disrupting amblyogenic factor. Added to the challenge of a thorough examination of very young children, is the weight of consequence if the amblyogenic factor is not identified and treated appropriately within clinically recommended time frames. Further, the poor visual function may be a symptom of more sinister underlying pathology impacting the visual pathway. This review presents an evidence-based, pragmatic approach to the diagnosis of amblyopia, as a means for guiding best practice for the care of children who present with reduced vision.
Clinical Profile of Amblyopia Patients Between 5-15 Years of Age
BACKGROUND The aim of the study is to-1. Diagnose strabismic, anisometropic and mixed amblyopia in age group 5-15 years. 2. Analyse these patients for age, sex, type of refractive error, type of squint, type of fixation pattern and classify them aetiologically. 3. Study effectiveness of different amblyopia treatments in this age group. MATERIALS AND METHODS Patients in 5-15 years of age in a period of two years were selected and assessed for amblyopia, which included a detailed history, visual acuity, retinoscopy, ocular movements and alignment, slit lamp examination, fundus examination. Patients were given amblyopia treatment and assessed for improvement. Settings and Design-Hospital-based descriptive study in a period of two years. RESULTS In 32 amblyopic patients, maximum patients were of age group between 5-7 years. 53.12% of patients were females. Amblyopia was predominant among anisometropic patients (75%) with maximum of refractive error difference between 2.00 D to 4.00 D. Amongst them, maximum amblyopes were having hypermetropia with astigmatism (37.50%). In the strabismic type, esotropia was more common. Patients showing more than 2 Snellen's line improvements after patching for 2 hrs. were 77.27% and for 6 hrs. were 22.72%. After part-time patching, maximum improvement in BCVA (best corrected visual acuity) was seen in anisometropes (P<0.0001) followed by strabismic (P=0.025) and least with mixed (P=0.026) amblyopes. CONCLUSION Amblyopia is treatable if detected earlier. Lack of community or preschool vision screening was the main cause for late pickup of amblyopic children for timely management and hence significant visual impairment associated with the condition.
The Clinical Profile of Moderate Amblyopia in Children Younger Than 7 Years
Archives of Ophthalmology, 2002
To describe the demographic and clinical characteristics of a cohort of children with moderate amblyopia participating in the Amblyopia Treatment Study 1, a randomized trial comparing atropine and patching. Methods: The children enrolled were younger than 7 years and had strabismic, anisometropic, or combined strabismic and anisometropic amblyopia. Visual acuity, measured with a standardized testing protocol using single-surround HOTV optotypes, was 20/40 to 20/100 in the amblyopic eye, with an intereye acuity difference of 3 or more logMAR lines. There were 419 children enrolled, 409 of whom met these criteria and were included in the analyses. The mean age of the 409 children was 5.3 years. The cause of the amblyopia was strabismus in 38%, anisometropia in 37%, and both strabismus and anisometropia in 24%. The mean visual acuity of the amblyopic eyes (ap-proximately 20/60) was similar among the strabismic, anisometropic, and combined groups (P=.24), but visual acuity of the sound eyes was worse in the strabismic group compared with the anisometropic group (PϽ.001). For the patients randomized into the patching group, 43% were initially treated for 6 hours per day, whereas 17% underwent full-time patching. Patients with poorer visual acuity in the amblyopic eye were prescribed more hours of patching than patients with better acuity (P=.003). Conclusions: In the Amblyopia Treatment Study 1, there were nearly equal proportions of patients with strabismic and anisometropic amblyopia. A similar level of visual impairment was found irrespective of the cause of amblyopia. There was considerable variation in treatment practices with regard to the number of hours of initial patching prescribed.