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American Family Physician Dec 2019Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services...
Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services Task Force recommends vision screening for all children at least once between three and five years of age to detect the presence of amblyopia or its risk factors. The American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Pediatrics recommend routine, age-appropriate red reflex testing, examination for signs of strabismus, and vision chart testing. Photoscreening may be a useful adjunct to traditional vision screening, but there is limited evidence that it improves visual outcomes. Treatments for amblyopia include patching, atropine eye drops, and optical penalization of the nonamblyopic eye. In children with moderate amblyopia, patching for two hours per day is as effective as six hours, and daily atropine is as effective as daily patching. Children younger than seven years receive the most benefit from treatment, but older children may still benefit. Amblyopia recurs in 25% of children, so continued surveillance is important.
Topics: Amblyopia; Child; Child, Preschool; Humans; Vision Screening
PubMed: 31845774
DOI: No ID Found -
Pediatric Clinics of North America Jun 2014Amblyopia refers to unilateral or bilateral reduction in best corrected visual acuity, not directly attributed to structural abnormality of the eye or posterior visual... (Review)
Review
Amblyopia refers to unilateral or bilateral reduction in best corrected visual acuity, not directly attributed to structural abnormality of the eye or posterior visual pathways. Early detection of amblyopia is crucial to obtaining the best response to treatment. Amblyopia responds best to treatment in the first few years of life. In the past several years a series of studies undertaken by the Pediatric Eye Disease Investigator Group (PEDIG) have been designed to evaluate traditional methods for treating amblyopia and provide evidence on which to base treatment decisions. This article summarizes and discusses the findings of the PEDIG studies to date.
Topics: Adolescent; Amblyopia; Blindness; Child; Child, Preschool; Humans; Treatment Outcome; Vision Screening; Visual Acuity
PubMed: 24852148
DOI: 10.1016/j.pcl.2014.03.006 -
Journal of the Neurological Sciences Oct 2022Amblyopia is a neurodevelopmental disorder caused by abnormal visual experience in early life that affects 3-5% of the population. Amblyopia results in a host of... (Review)
Review
Amblyopia is a neurodevelopmental disorder caused by abnormal visual experience in early life that affects 3-5% of the population. Amblyopia results in a host of monocular and binocular visual afferent function deficits including reduced visual acuity, contrast sensitivity, depth perception, interocular suppression, and efferent function abnormalities such as unstable and inaccurate fixation. Conventional treatments such as patching therapy and newer dichoptic treatments are not always successful as 30-40% of patients experience recurrence/regression of amblyopia. There are numerous review articles focused on visual afferent function deficits and treatment modalities and outcomes in amblyopia. Recently, the advent of high spatial and temporal resolution eye trackers has spurred studies on fixation eye movements (FEMs) in healthy controls and neurologic and ophthalmic disorders. In this focused review, we will summarize studies evaluating FEM abnormalities in amblyopia. We will first describe the common devices and techniques used to quantify fixation abnormalities, and then highlight the importance of systematically evaluating the eye movements under different viewing conditions and describe the parameters crucial in assessing FEM abnormalities in amblyopia. We will summarize the evidence suggesting that FEM abnormalities are not limited to the amblyopic eye only but also affects the fellow eye and that FEM abnormalities can serve as biomarkers to predict the impact of amblyopia on visual functions. Beyond diagnosis, we will discuss the treatment and prognostic implications of the evaluation of FEM abnormalities in clinical practice.
Topics: Amblyopia; Biomarkers; Eye Movements; Humans; Vision, Binocular; Visual Acuity
PubMed: 36007287
DOI: 10.1016/j.jns.2022.120373 -
JAMA Jan 2021
Topics: Amblyopia; Child; Humans; Infant; Strabismus; Vision Screening
PubMed: 33496776
DOI: 10.1001/jama.2020.5741 -
Pediatric Clinics of North America Feb 2003Amblyopia is a serious medical condition affecting tens of millions of individuals around the world. For the most part it is correctable, assuming that it is promptly... (Review)
Review
Amblyopia is a serious medical condition affecting tens of millions of individuals around the world. For the most part it is correctable, assuming that it is promptly recognized and vigorously treated. Amblyopia may result from form deprivation, anisometropia, or strabismus in infants and young children. Basic research in animal models has shown that the major pathologic changes in amblyopia occur in the visual cortex of the brain. The mainstay of treatment remains patching, although penalization has a role to play in the management of moderate degrees of amblyopia. Better methods for early identification of patients with amblyopia are being developed, along with newer novel methods of treatment.
Topics: Amblyopia; Child; Humans; Infant; Vision Screening
PubMed: 12713112
DOI: 10.1016/s0031-3955(02)00107-4 -
Survey of Ophthalmology 1995Over the past thirty years, much has been learned about the physiological basis for amblyopia. For many years amblyopia was considered to be a retinal disorder; it has... (Review)
Review
Over the past thirty years, much has been learned about the physiological basis for amblyopia. For many years amblyopia was considered to be a retinal disorder; it has now been well established through animal studies that amblyopia represents functional and morphological effects of visual deprivation on the visual cortex and the lateral geniculate nucleus. With this knowledge has come the recognition of a "sensitive period" of development of the visual system, during which time visual deprivation causes amblyopia. The best approach to managing amblyopia is to detect amblyogenic factors before the age of two years and prevent it through eliminating the causes of visual deprivation. When amblyopia exists, it can be cured if adequately treated in children less than 6-7 years of age. Even in older patients, visual improvement can be achieved with therapy. Current research is aimed at developing substances and delivery modes that will allow the sensitive period of visual development to be manipulated, increasing the period during which it can develop and enhancing preventative and therapeutic measures. In this review selected literature contributing to current understanding of causes, prevention and treatment of amblyopia is discussed. Although many new treatment modalities have been tried, occlusion still seems to be the most successful therapy.
Topics: Amblyopia; Animals; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Psychophysics; Sensory Deprivation; Visual Cortex
PubMed: 8545799
DOI: 10.1016/s0039-6257(95)80044-1 -
Current Opinion in Ophthalmology Oct 1996New knowledge of the pathophysiology of amblyopia has evolved through animal research over the past 30 years. We now know that development and treatment of amblyopia... (Review)
Review
New knowledge of the pathophysiology of amblyopia has evolved through animal research over the past 30 years. We now know that development and treatment of amblyopia have a critical and sensitive period. After more than a millennium, patching of the dominant eye remains the cornerstone of amblyopia treatment, and compliance plays an important role in its effectiveness. Compliance can now be measured objectively with an occlusion monitoring device. The first successful attempts have been made to pharmacologically influence the plasticity of the human visual system.
Topics: Amblyopia; Animals; Eye Movements; Humans; Visual Acuity
PubMed: 10165110
DOI: 10.1097/00055735-199610000-00003 -
Journal Francais D'ophtalmologie Jun 2014Amblyopia is a developmental disorder of the entire visual system, including the extra-striate cortex. It manifests mainly by impaired visual acuity in the amblyopic... (Review)
Review
Amblyopia is a developmental disorder of the entire visual system, including the extra-striate cortex. It manifests mainly by impaired visual acuity in the amblyopic eye. However, other abnormalities of visual function can be observed, such as decreased contrast sensitivity and stereoscopic vision, and some abnormalities can be found in the "good" eye. Amblyopia occurs during the critical period of brain development. It may be due to organic pathology of the visual pathways, visual deprivation or functional abnormalities, mainly anisometropia or strabismus. The diagnosis of amblyopia must be confirmed prior to treatment. Confirmation is based on cycloplegic refraction, visual acuity measurement and orthoptic assessment. However, screening for amblyopia and associated risk factors permits earlier diagnosis and treatment. The younger the child, the more effective the treatment, and it can only be achieved during the critical period. It requires parental cooperation in order to be effective and is based on occlusion or penalization of the healthy eye. The amblyopic eye may then develop better vision. Maintenance therapy must be performed until the end of the critical period to avoid recurrence.
Topics: Amblyopia; Diagnostic Techniques, Ophthalmological; Humans; Patient Education as Topic; Prognosis; Refraction, Ocular; Visual Acuity
PubMed: 24703193
DOI: 10.1016/j.jfo.2014.01.004 -
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 -
Lancet (London, England) Apr 2006Results from recent randomised clinical trials in amblyopia should change our approach to screening for and treatment of amblyopia. Based on the current evidence, if one... (Review)
Review
Results from recent randomised clinical trials in amblyopia should change our approach to screening for and treatment of amblyopia. Based on the current evidence, if one screening session is used, screening at school entry could be the most reasonable time. Clinicians should preferably use age-appropriate LogMAR acuity tests, and treatment should only be considered for children who are clearly not in the typical range for their age. Any substantial refractive error should be corrected before further treatment is considered and the child should be followed in spectacles until no further improvement is recorded, which can take up to 6 months. Parents and carers should then be offered an informed choice between patching and atropine drops. Successful patching regimens can last as little as 1 h or 2 h a day, and successful atropine regimens as little as one drop twice a week. Intense and extended regimens might not be needed in initial therapy.
Topics: Amblyopia; Atropine; Bandages; Child, Preschool; Humans; Mydriatics; Patient Compliance; Refractive Errors; Vision Screening; Visual Acuity
PubMed: 16631913
DOI: 10.1016/S0140-6736(06)68581-4