Amblyopia in Astigmatic Infants and Toddlers (original) (raw)

Amblyopia in astigmatic preschool children

Journal of Vision, 2002

Best-corrected acuity was measured for vertical and horizontal gratings and for recognition acuity optotypes (Lea Symbols) in a group of three-to five-year-old children with a high prevalence of astigmatism. Results showed meridional amblyopia (MA) among children with simple/compound myopic or mixed astigmatism, due to reduced acuity for horizontal gratings. Children with simple/ compound hyperopic astigmatism showed no MA, but did show reduced acuity for both grating orientations. Reduced best-corrected recognition acuity was shown by both myopic/mixed and hyperopic astigmats. These results suggest that optical correction of astigmatism should be provided prior to age three to five years, to prevent development of amblyopia.

Optical Treatment of Amblyopia in Astigmatic Children

Ophthalmology, 2007

To compare the effectiveness of eyeglass treatment of astigmatism-related amblyopia in children younger than 8 years (range, 4.75-7.99 years) versus children 8 years of age and older (range, 8.00-13.53 years) over short (6-week) and long (1-year) treatment intervals. Prospective, interventional, comparative case-control study. Four hundred forty-six nonastigmatic (right and left eye, <0.75 diopters [D]) and 310 astigmatic (RE, > or =1.00 D) Native American (Tohono O'odham) children in kindergarten or grades 1 through 6. Eyeglass correction of refractive error, prescribed for full-time wear, in astigmatic children. Amount of change in mean right-eye best-corrected letter visual acuity for treated astigmatic children versus untreated, age-matched nonastigmatic children after short (6-week) and long (1-year) treatment intervals. Astigmatic children had significantly reduced mean best-corrected visual acuity at baseline compared to nonastigmatic children. Astigmats showed significantly greater improvement in mean best-corrected visual acuity (0.08 logarithm of the minimum angle of resolution [logMAR] unit; approximately 1 line), than the nonastigmatic children (0.01 logMAR unit) over the 6-week treatment interval. No additional treatment effect was observed between 6 weeks and 1 year. Treatment effectiveness was not dependent on age group (<8 years vs. > or =8 years) and was not influenced by previous eyeglass treatment. Despite significant improvement, mean best-corrected visual acuity in astigmatic children remained significantly poorer than in nonastigmatic children after 1 year of eyeglass treatment, even when analyses were limited to results from highly compliant children. Sustained eyeglass correction results in significant improvement in best-corrected visual acuity in astigmatic children, including those previously believed to be beyond the sensitive period for successful treatment.

Infant astigmatism and meridional amblyopia

Vision Research, 1985

The orientation preferences of 70 infants aged 7 to 53 weeks with significant astigmatism Il.0 or more dioptcrs (D)] were measured using a preferential looking procedure with paired gratings. The

Infant astigmatism: its disappearance with age

Vision Research, 1980

Abatraet-Photorefractive measurements, including longitudinal measures on a group of infants, show that the marked astigmatism that is common during the first year of life declines to adult levels of incidence by about 18 monthr

Astigmatism and the development of myopia in children

Vision Research, 2000

While it is now established that astigmatism is more prevalent in infants and young children than in the adult population, little is known about the functional significance of this astigmatism, especially its role, if any, in emmetropization and the development of myopia. Manifest refractions (mean of 16 per subject) were obtained from 245 subjects starting in the first year, with 6 -23 years of regular follow-up. Results showed that infantile astigmatism is associated with increased astigmatism and myopia during the school years. Two possible mechanisms underlying this association are discussed: (1) infantile astigmatism disrupts focusing mechanisms; and (2) ocular growth induces astigmatism and myopia.

Changes in visual function following optical treatment of astigmatism-related amblyopia

Vision Research, 2008

Effects of optical correction on best-corrected grating acuity (vertical (V), horizontal (H), oblique (O)), vernier acuity (V, H, O), contrast sensitivity (1.5, 6.0, and 18.0 cy/deg spatial frequency, V and H), and stereoacuity were evaluated prospectively in 4-to 13-year-old astigmats and a non-astigmatic age-matched control group. Measurements made at baseline (eyeglasses dispensed for astigmats), 6 weeks, and 1 year showed greater improvement in astigmatic than non-astigmatic children for all measures. Treatment effects occurred by 6 weeks, and did not differ by cohort (<8 vs. P8 years), but astigmatic children did not attain normal levels of visual function.

Prevalence of Astigmatism in 4- to 6-Year-Old Population of Mashhad, Iran

Background: Astigmatism is a correctable cause of visual impairment in childhood. It increases the incidence of amblyopia in children. Objectives: In this report, we intended to describe the prevalence of the amount and axis of astigmatism, astigmatism components, and associations of astigmatism with age, gender and spherical equivalent in under six years old children through a population-based study. Patients and Methods: This report was a part of the cross-sectional Mashhad Eye Study in which 3675 of 4-6 years old children in Mashhad kindergartens were selected through random cluster sampling, of which, 3701 participated in the study (response rate: 98.3%). Refractive astigmatism was determined using a retinoscope (HEINE BETA-200, Germany) and defined as a cylinder power of more than 0.5 diopter (D). Corneal astigmatism was measured using Pentacam (Oculus Optikgerate GmbH, Germany). Results: The prevalence of refractive astigmatism of more than 0.5D in at least one eye was 51.4% (...

Risk Factors for Amblyopia in the Vision in Preschoolers (VIP) Study

2013

Three-to 5-year-old Head Start preschoolers from 5 clinical centers, overrepresenting children with vision disorders. Methods: All children underwent comprehensive eye examinations, including threshold visual acuity (VA), cover testing, and cycloplegic retinoscopy, performed by VIP-certified optometrists and ophthalmologists who were experienced in providing care to children. Monocular threshold VA was tested using a single-surround HOTV letter protocol without correction, and retested with full cycloplegic correction when retest criteria were met. Unilateral amblyopia was defined as an interocular difference in best-corrected VA of 2 lines or more. Bilateral amblyopia was defined as best-corrected VA in each eye worse than 20/50 for 3-year-olds and worse than 20/40 for 4-to 5-year-olds. Main Outcome Measures: Risk of amblyopia was summarized by the odds ratios and their 95% confidence intervals estimated from logistic regression models. Results: In this enriched sample of Head Start children (n ¼ 3869), 296 children (7.7%) had unilateral amblyopia, and 144 children (3.7%) had bilateral amblyopia. Presence of strabismus (P < 0.0001) and greater magnitude of significant refractive errors (myopia, hyperopia, astigmatism, and anisometropia; P < 0.00001 for each) were associated independently with an increased risk of unilateral amblyopia. Presence of strabismus, hyperopia of 2.0 diopters (D) or more, astigmatism of 1.0 D or more, or anisometropia of 0.5 D or more were present in 91% of children with unilateral amblyopia. Greater magnitude of astigmatism (P < 0.0001) and bilateral hyperopia (P < 0.0001) were associated independently with increased risk of bilateral amblyopia. Bilateral hyperopia of 3.0 D or more or astigmatism of 1.0 D or more were present in 76% of children with bilateral amblyopia. Conclusions: Strabismus and significant refractive errors were risk factors for unilateral amblyopia. Bilateral astigmatism and bilateral hyperopia were risk factors for bilateral amblyopia. Despite differences in selection of the study population, these results validated the findings from the Multi-Ethnic Pediatric Eye Disease Study and Baltimore Pediatric Eye Disease Study. Ophthalmology 2014;121:622-629 ª 2014 by the American Academy of Ophthalmology.