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Journal of AAPOS : the Official... Feb 2023To determine whether deficits in manual dexterity in children with amblyopia improve after binocular amblyopia treatment and whether improvements are related to age at...
PURPOSE
To determine whether deficits in manual dexterity in children with amblyopia improve after binocular amblyopia treatment and whether improvements are related to age at treatment, baseline sensory status, or amount of improvement in sensory status with treatment.
METHODS
Manual dexterity (Movement Assessment Battery for Children-2), visual acuity, fusion, suppression, and stereoacuity were measured at baseline and after 4-8 weeks of binocular amblyopia in 134 children with amblyopia, including 75 children in the "younger group" (aged 3 to <7 years) and 59 in the "older group" (aged 7-10 years), and in 40 age-similar control children.
RESULTS
Baseline manual dexterity standard scores of amblyopic children were significantly below those of controls in both the younger (8.81 ± 0.33 vs 11.80 ± 0.60 [P < 0.0001]) and older groups (7.19 ± 0.34 vs 9.75 ± 0.57 [P = 0.00013]). After 4-8 weeks of binocular amblyopia treatment, the younger group standard score improved to 9.85 ± 0.35 and the older group improved to 8.08 ± 0.39, but both groups remained significantly lower than controls (P = 0.03 and P = 0.01, resp.). Improvement in manual dexterity standard score was not associated with any baseline factors but was weakly correlated with the amount of visual acuity improvement (r = 0.26; 95% CI, 0.09-0.41) CONCLUSIONS: Manual dexterity impairments are common among children with amblyopia. In our study cohort, binocular amblyopia treatment improved visual acuity and manual dexterity.
Topics: Child; Humans; Amblyopia; Vision, Binocular; Video Games; Computers, Handheld; Visual Acuity
PubMed: 36567045
DOI: 10.1016/j.jaapos.2022.10.006 -
Visual Neuroscience Jan 2018Although historically, treatment of amblyopia has been recommended prior to closure of a critical window in visual development, the existence and duration of that... (Review)
Review
Although historically, treatment of amblyopia has been recommended prior to closure of a critical window in visual development, the existence and duration of that critical window is currently unclear. Moreover, there is clear evidence, both from animal and human studies of deprivation amblyopia, that there are different critical windows for different visual functions and that monocular and binocular deprivation have different neural and behavioral consequences. In view of the spectrum of critical windows for different visual functions and for different types of amblyopia, combined with individual variability in these windows, treatment of amblyopia has been increasingly offered to older children and adults. Nevertheless, treatment beyond the age of 7 years tends to be, on average, less effective than in younger children, and the high degree of variability in treatment response suggests that age is only one of many factors determining treatment response. Newly emerging treatment modalities may hold promise for more effective treatment of amblyopia at older ages. Additional studies are needed to characterize amblyopia by using new and existing clinical tests, leading to improved clinical classification and better prediction of treatment response. Attention also needs to be directed toward characterizing and measuring the impact of amblyopia on the patients' functional vision and health-related quality of life.
Topics: Age Factors; Aging; Amblyopia; Child; Child, Preschool; Humans
PubMed: 29905125
DOI: 10.1017/S0952523817000220 -
Graefe's Archive For Clinical and... May 2023Amblyopia is a neurodevelopmental disorder characterized by functional deficits in the visual cortex. Functional magnetic resonance imaging (fMRI) is the most commonly... (Review)
Review
Amblyopia is a neurodevelopmental disorder characterized by functional deficits in the visual cortex. Functional magnetic resonance imaging (fMRI) is the most commonly used neuroimaging technique for investigating amblyopia. Herein, we systematically searched a PubMed database from inception to December 2021 to highlight the current progress and promises about fMRI technology in amblyopia; amblyopia's neural mechanism, the comparison of different types of amblyopia, and the evaluation of the therapeutic effect were explored. Relevant articles published in English and appropriate cross-references were considered for inclusion, including basic studies, imaging techniques, clinical diagnostic and therapeutic studies, case series, and reviews.
Topics: Humans; Amblyopia; Visual Cortex; Magnetic Resonance Imaging
PubMed: 36282454
DOI: 10.1007/s00417-022-05826-z -
Optometry and Vision Science : Official... Oct 2017Increasing evidence indicates that childhood binocular vision disorders that lead to stereodeficiency may be treated in adulthood. Reports of patients who gain... (Review)
Review
SIGNIFICANCE
Increasing evidence indicates that childhood binocular vision disorders that lead to stereodeficiency may be treated in adulthood. Reports of patients who gain stereopsis as adults indicate that this achievement provides for a qualitatively different and dramatically improved sense of space and depth.
PURPOSE
Increasing evidence suggests that stereopsis can be achieved in adult patients despite long-standing binocular disorders. We polled individuals who gained stereopsis as adults to ascertain their initial binocular disorders, the length of time they were stereodeficient, effective treatments, and the nature of their recovered stereovision.
METHODS
A questionnaire was posted online and announced in a brief article in the journal Vision Development and Rehabilitation.
RESULTS
Of the 63 responders, 56 (89%) reported strabismus and/or amblyopia, and 55 (87%) indicated that they had been stereodeficient for as long as they could remember. All but seven participants (89%) achieved stereovision through vision training or a combination of surgery and vision training, and many reported vivid visual changes.
CONCLUSIONS
Despite childhood binocular disorders, patients may be able to achieve stereopsis following interventions in adulthood. This achievement provides for a qualitatively different and dramatically improved sense of space and depth.
Topics: Adult; Amblyopia; Depth Perception; Humans; Ophthalmologic Surgical Procedures; Strabismus; Treatment Outcome; Vision, Binocular
PubMed: 28858047
DOI: 10.1097/OPX.0000000000001115 -
Clinical & Experimental Optometry Nov 2019Aniseikonia is a difference in the perceived size or shape of images between eyes, and can arise from a variety of physiological, neurological, retinal, and optical... (Review)
Review
Aniseikonia is a difference in the perceived size or shape of images between eyes, and can arise from a variety of physiological, neurological, retinal, and optical causes. Aniseikonia is associated with anisometropia, as both anisometropia itself and the optical correction for anisometropia can cause aniseikonia. Image size differences above one to three per cent can be clinically symptomatic. Common symptoms include asthenopia, headache and diplopia in vertical gaze. Size differences of three and more impair binocular visual functions such as binocular summation and stereopsis. Above five per cent of aniseikonia, binocular inhibition or suppression tend to occur to prevent diplopia and confusion. Aniseikonia can be measured using a range of techniques and can be corrected or reduced by prescribing contact lenses or specially designed spectacle lenses. Subjective testing of aniseikonia is the only way to accurately measure the overall perceived amount of aniseikonia. However, currently it is not routinely assessed in most clinical settings. At least two-thirds of patients with amblyopia have anisometropia, thus we may expect aniseikonia to be common in patients with anisometropic amblyopia. However, aniseikonia may not be experienced by the patient under normal binocular viewing conditions if the image from the amblyopic eye is of poor quality or is too strongly suppressed for image size differences to be recognised. This lack of binocular simultaneous perception in amblyopia may also prevent the measurement of aniseikonia, as most common techniques require direct comparisons of images seen by each eye. Current guidelines for the treatment of amblyopia advocate full correction of anisometropia to equalise image clarity, but do not address aniseikonia. Significant image size differences between eyes may lead to suppression and abnormal binocular adaptations. It is possible that correcting anisometropia and aniseikonia simultaneously, particularly at the initial diagnosis of anisometropia, would reduce the need to develop suppression and improve treatment outcomes for anisometropic amblyopia.
Topics: Amblyopia; Aniseikonia; Anisometropia; Humans
PubMed: 30791133
DOI: 10.1111/cxo.12881 -
Arquivos Brasileiros de Oftalmologia 2016Abnormalities in visual processing caused by visual deprivation or abnormal binocular interaction may induce amblyopia, which is characterized by reduced visual acuity.... (Review)
Review
Abnormalities in visual processing caused by visual deprivation or abnormal binocular interaction may induce amblyopia, which is characterized by reduced visual acuity. Occlusion therapy, the conventional treatment, requires special attention as occlusion of the fellow normal eye may reduce its visual acuity and impair binocular vision. Besides recovering visual acuity, some researchers have recommended restoration of stereoacuity and motor fusion and reverse suppression in order to prevent diplopia. Recent studies have documented that the amblyopic visual cortex has a normal complement of cells but reduced spatial resolution and a disordered topographical map. Changes occurring in the late sensitive period selectively impact the parvocellular pathway. Distinct morphophysiologic and psychophysical deficits may demand individualization of therapy, which might provide greater and longer-lasting residual plasticity in some children.
Topics: Age of Onset; Amblyopia; Child; Humans; Neuronal Plasticity; Visual Acuity
PubMed: 27982220
DOI: 10.5935/0004-2749.20160099 -
European Journal of Ophthalmology Jan 2022The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable...
The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. After the World Health Organization (WHO) recognized COVID-19 as a global pandemic on March 11, 2020, widespread changes and restrictions to social and sanitary practices have presented significant issues in access to eye care during the COVID-19 pandemic. A reduction of more than 80% in pediatric eye care volume up to its total cessation has been observed in different departments. In this scenario, reduced or absent eyesight, due to delay in timely treatment of amblyopic conditions, could create major, long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities and the ability to access public services. Processes coming out of lockdown should be gradually easing restrictions giving priority to ophthalmology and eye care facilities so that amblyopia does not remain unattended and irreversible as in adults due to lack of timely treatments. If not reversible, this process could lead to a dramatic increase in disability and unsustainable social costs for many governments.
Topics: Adult; Amblyopia; COVID-19; Child; Communicable Disease Control; Disease Outbreaks; Humans; Myopia; Pandemics; SARS-CoV-2
PubMed: 34751045
DOI: 10.1177/11206721211053175 -
Romanian Journal of Ophthalmology 2017For many years, amblyopia was regarded as a disorder of the visual system in which an organic cause could not be identified. Optical Coherence Tomography opens new... (Review)
Review
For many years, amblyopia was regarded as a disorder of the visual system in which an organic cause could not be identified. Optical Coherence Tomography opens new horizons in understanding the etiopathology of amblyopia and seems to highlight morphologic anomalies in the retina of the amblyopic eye. The objective of this paper is to analyze the macular thickness, optic nerve changes, and choroidal thickness found in patients diagnosed with amblyopia based on trials reported in the literature. This study analyzes 30 clinical trials regarding amblyopia evaluation with Optical Coherence Tomography. The research articles analyzed were published between 2006 - 2016 and were identified on PubMed database. 19 research studies focused on macular and nerve optic changes, 7 on choroidal changes and 6 on retinal changes after occlusion. The results were discussed according to the type of amblyopia, alteration of macular thickness, optic nerve changes, ganglion cell layer changes, and alteration of choroidal thickness. The results are of great variability, and it seems that macula and choroid involvement is more frequently suggested compared with optic nerve involvement. OCT = Optical Coherence Tomography, RNFL = Retinal Nerve Fiber Layer, GCC = Ganglion Cell Complex, ACD = Anterior Chamber Depth, BCVA = Best Corrected Visual Acuity.
Topics: Amblyopia; Animals; Humans; Macula Lutea; Nerve Fibers; Retinal Ganglion Cells; Tomography, Optical Coherence
PubMed: 29450380
DOI: 10.22336/rjo.2017.18 -
Journal of AAPOS : the Official... Dec 2017Reading is a major life activity, as recognized by the US Congress in the Americans with Disabilities Act Amendments Act of 2008, and the education code of most US...
Reading is a major life activity, as recognized by the US Congress in the Americans with Disabilities Act Amendments Act of 2008, and the education code of most US states requires schools to evaluate reading and implement reading programs to addresses students' reading difficulties. Currently, such legislation is employed to identify accommodations needed for children with bilateral visual impairment and for children with dyslexia and/or related learning disabilities. Yet recent research has shown that children with the most common form of monocular visual impairment-amblyopia-read slowly. Slow reading can be detrimental to academic performance and learning, which in turn may affect self-esteem. Parents and educators can work together to implement accommodations (eg, extra time) to help amblyopic students succeed in their daily school tasks, and improve their performance on the timed, standardized tests that are critical for promotion and admission to magnet schools, TAG programs, high schools, and colleges. Children with other visual disorders that cause visual impairment in one eye (eg, glaucoma, cataract, trauma, etc) should also be considered for academic accommodations.
Topics: Accommodation, Ocular; Amblyopia; Child; Child, Preschool; Dyslexia; Educational Status; Humans; Infant; Ophthalmology; Pediatrics; Psychology, Child; Reading
PubMed: 28870794
DOI: 10.1016/j.jaapos.2017.06.013 -
Strabismus Dec 2018: The purpose of this study was to establish the prevalence of amblyopia in children, aged 4 to 10 years, in Bulgaria, who underwent a complete eye examination.: The...
: The purpose of this study was to establish the prevalence of amblyopia in children, aged 4 to 10 years, in Bulgaria, who underwent a complete eye examination.: The study was designed as cross-sectional epidemiological study, and the results were calculated in percentages. A complete ophthalmological examination was performed on 1,675 children, aged 4 to 10 years (mean age 7.7 years), during the period 01 Feb 2017-21 April 2017, in five cities, in the western part of Bulgaria. All children were verbal, none of them had a neurologic deficit or mental development delay and a complete examination was successfully performed. The ophthalmological examination consisted of: autorefractometry (using pediatric autorefractor with infrared photoretinoscopy), visual acuity, best-corrected visual acuity (BCVA) and visual acuity with pinhole occluder, cover/uncover and alternate cover test, Worth four-dot test, stereopsis, biomicroscopy and funds examination. Amblyopia was defined as reduction of the BCVA for near and far distances under 40/60 on one or on both eyes in the absence of any pathology of the eye, excluding a pathology leading to stimulus deprivation amblyopia, and in the presence of an amblyogenic factor.: Out of 1,675 children, 42 (2.5%) were diagnosed with amblyopia: 7% had strabismic amblyopia (3), 59% had anisometropic amblyopia (25), 31% had isoametropic amblyopia (13), and 3% deprivation amblyopia (1). Unilateral amblyopia was diagnosed in 73% (27) of the cases and bilateral amblyopia in 27% (15). For 45% (754) of the children, it was their first visit to an ophthalmologist.: The prevalence of amblyopia among these patients (2.5%) is correlating well with the expected, based on data from other authors, between 1.5% and 3.5%. The fact that nearly half of the children (45%) have not been examined by an ophthalmologist is, however, alarming. The lack of a national screening program in Bulgaria could be the main reason. Other factors include: insufficient number of pediatric ophthalmologists in the country and the lack of awareness among the parents.
Topics: Amblyopia; Bulgaria; Child; Child, Preschool; Cross-Sectional Studies; Depth Perception; Female; Humans; Male; Prevalence; Visual Acuity
PubMed: 30325246
DOI: 10.1080/09273972.2018.1530266