TERMINOLOGY
CLINICAL CLARIFICATION
• Neurodevelopmental disorder characterized by decreased visual acuity, poor or absent stereopsis, and suppression of information from one eye, as a result of misuse or disuse during critical period(s) of visual development
CLASSIFICATION 2. 1
• Strabismic amblyopia
• Anisometropic or refractive amblyopia o Many patients are classified as having mixed strabismic and anisometropic amblyopia
• Deprivational amblyopia
DIAGNOSIS
CLINICAL PRESENTATION
• History o Parent/Guardian(s) suspect vision problems or unequal vision between eyes o Frequent head tilting by a child may be a sign of amblyopia compensation o Severe cases may experience visual difficulties
- Poor visual acuity
- Poor depth perception
- Poor
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Cover Test- Ocular alignment (repeat three times for reproducibility) 11 c Distance and near c Cover-uncover and alternate-cover tests c Look For refixation movement c Invery young children amblyopia should be suspected if covering of one eye is resisted more strongly than covering the other 11 c Determination of coordination at 20 feet distance- use loose prism (5 prism diopters) c Determination of coordination at 1foot distance- use loose prisms (6 prism diopters and 10 prism diopters) o 3. Retinoscopy (skiametry) c Lens bar containing lenses of c -0.75 diopter, +0.75 diopter, +1.50 diopter, and +2.25 diopter c View cartoon film on screen at 20 feet c Through +1.50 diopter lenses in trial Frame o 4. Inspection For organic problems o Hand magnifier and ophthalmascope c Check for external and internal ocular …show more content…
• Amblyopia is a neurodevelopmental disorder where functional reduction in the visual acuity of an eye is reduced due to o Strabismus o Anisometropia o A combination of strabismus and anisometropia o Disuse
• Amblyopia symptoms are difficult to identify without visual acuity testing
• Measurement of visual acuity is the first step in diagnosis and is part of recommended childhood screening programs
• Surgery may be required for amblyogenic abnormalities prior to amblyopia treatment
• Most patients treated For 6 months before the age of 7 will have good visual acuity at 15years
• Some residual monocular and binocular visual impairment often occurs
URGENT ACTION
• Patients with any risk Factors are referred to a vision specialist
• Follow screening guidelines to ensure early diagnosis and treatment of amblyopia to improve outcomes
• Corrective refractive interventions proceed occlusion or pharmaceutical therapy
PITFALLS
• Compliance time for occlusion therapy (patching) can be extremely variable o Compliance during two studies averaged less than 50% 12
- Increased clinic attendance was associated with greater compliance
- Prolonged treatment duration was associated with less compliance o Compliance is associated with improved outcomes