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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 -
Visual Neuroscience Jan 2018Emerging technologies are now giving us unprecedented access to manipulate brain circuits, shedding new light on treatments for amblyopia. This research is identifying... (Review)
Review
Emerging technologies are now giving us unprecedented access to manipulate brain circuits, shedding new light on treatments for amblyopia. This research is identifying key circuit elements that control brain plasticity and highlight potential therapeutic targets to promote rewiring in the visual system during and beyond early life. Here, we explore how such recent advancements may guide future pharmacological, genetic, and behavioral approaches to treat amblyopia. We will discuss how animal research, which allows us to probe and tap into the underlying circuit and synaptic mechanisms, should best be used to guide therapeutic strategies. Uncovering cellular and molecular pathways that can be safely targeted to promote recovery may pave the way for effective new amblyopia treatments across the lifespan.
Topics: Amblyopia; Cognitive Behavioral Therapy; Gene-Environment Interaction; Humans; Molecular Targeted Therapy; Pharmaceutical Preparations
PubMed: 29905118
DOI: 10.1017/S0952523817000256 -
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 -
Neural Plasticity 2019Amblyopia is a neurodevelopmental visual disorder arising from decorrelated binocular experience during the critical periods of development. The hallmark of amblyopia is... (Review)
Review
Amblyopia is a neurodevelopmental visual disorder arising from decorrelated binocular experience during the critical periods of development. The hallmark of amblyopia is reduced visual acuity and impairment in binocular vision. The consequences of amblyopia on various sensory and perceptual functions have been studied extensively over the past 50 years. Historically, relatively fewer studies examined the impact of amblyopia on visuomotor behaviours; however, research in this area has flourished over the past 10 years. Therefore, the aim of this review paper is to provide a comprehensive review of current knowledge about the effects of amblyopia on eye movements, upper limb reaching and grasping movements, as well as balance and gait. Accumulating evidence indicates that amblyopia is associated with considerable deficits in visuomotor behaviour during amblyopic eye viewing, as well as adaptations in behaviour during binocular and fellow eye viewing in adults and children. Importantly, due to amblyopia heterogeneity, visuomotor development in children and motor skill performance in adults may be significantly influenced by the etiology and clinical features, such as visual acuity and stereoacuity. Studies with larger cohorts of children and adults are needed to disentangle the unique contribution of these clinical characteristics to the development and performance of visuomotor behaviours.
Topics: Adaptation, Physiological; Amblyopia; Animals; Gait; Humans; Psychomotor Performance; Vision, Binocular; Visual Acuity
PubMed: 31281344
DOI: 10.1155/2019/6817839 -
American Family Physician Sep 1999Normal visual development is rapid during the first six months of life and continues through the first decade. Young children are uniquely sensitive to conditions that... (Review)
Review
Normal visual development is rapid during the first six months of life and continues through the first decade. Young children are uniquely sensitive to conditions that interfere with vision and visual development. Amblyopia, or functionally defective development of the central visual system, may be caused by common vision problems such as strabismus, uncorrected refractive errors and deprivation secondary to occlusion. Prematurity is especially associated with eye pathology, including retinopathy of prematurity, amblyopia, strabismus and refractive errors. When detected early, amblyopia and many other childhood vision abnormalities are treatable, but the potential for correction and normal visual development is inversely related to age. Since many affected children are asymptomatic, early detection of abnormal visual function requires effective screening throughout early childhood. Special considerations apply to screening examinations of children born prematurely.
Topics: Age Factors; Amblyopia; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Infant, Premature; Patient Education as Topic; Teaching Materials; Vision Disorders; Vision Screening; Vision, Ocular
PubMed: 10498116
DOI: No ID Found -
JPMA. the Journal of the Pakistan... Mar 2023The narrative review was planned to investigate the efficiency of binocular treatment for amblyopic children, and to compare it with the standard methods. Literature... (Review)
Review
The narrative review was planned to investigate the efficiency of binocular treatment for amblyopic children, and to compare it with the standard methods. Literature search was conducted for articles in English language available on PubMed, Cochrane Library, Embase, Medline and PsycInfo databases as well as through bibliographies of peer-reviewed studies. Studies in the field of binocular treatment for amblyopia were included. Visual outcomes considered were visual acuity, types of amblyopia and stereoacuity. Studies on deprivation amblyopia, animal studies, literature review of amblyopia treatment, case reports, and trials targeting participants in whom previous amblyopia treatment had failed were excluded. Of the 40 studies found, 21(52.5%) met the inclusion criteria. Visual acuity and binocular function improved with binocular treatment for treating amblyopia in children by decreasing suppression depth extent and increasing stereopsis. Binocular treatment for amblyopic children was found to be an effective and fast process for the recovery of visual functions, especially in the critical time of visual development.
Topics: Animals; Amblyopia; Vision, Binocular; Visual Acuity; Databases, Factual
PubMed: 36932768
DOI: 10.47391/JPMA.6216 -
British Medical Bulletin Sep 2016With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in... (Review)
Review
INTRODUCTION OR BACKGROUND
With a prevalence of 2-5%, amblyopia is the most common vision deficit in children in the UK and the second most common cause of functional low vision in children in low-income countries.
SOURCES OF DATA
Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov, ISRCTN, UKCRN portfolio database).
AREAS OF AGREEMENT
Screening and treatment at the age of 4-5 years are cost efficient and clinically effective. Optical treatment (glasses) alone can improve visual acuity, with residual amblyopia treated by part-time occlusion or pharmacological blurring of the better-seeing eye. Treatment after the end of the conventional 'critical period' can improve vision, but in strabismic amblyopia carries a low risk of double vision.
AREAS OF CONTROVERSY
It is not clear whether earlier vision screening would be cost efficient and associated with better outcomes. Optimization of treatment by individualized patching regimes or early start of occlusion, and novel binocular treatment approaches may enhance adherence to treatment, provide better outcomes and shorten treatment duration.
GROWING POINTS
Binocular treatments for amblyopia.
AREAS TIMELY FOR DEVELOPING RESEARCH
Impact of amblyopia on education and quality of life; optimal screening timing and tests; optimal administration of conventional treatments; development of child-friendly, effective and safe binocular treatments.
Topics: Amblyopia; Child; Cost-Benefit Analysis; Early Diagnosis; Eyeglasses; Humans; Mass Screening; Prevalence; Quality of Life; Treatment Outcome; United Kingdom
PubMed: 27543498
DOI: 10.1093/bmb/ldw030 -
The Cochrane Database of Systematic... Jul 2014Amblyopia is reduced visual acuity in one or both eyes in the absence of any demonstrable abnormality of the visual pathway. It is not immediately resolved by the... (Review)
Review
BACKGROUND
Amblyopia is reduced visual acuity in one or both eyes in the absence of any demonstrable abnormality of the visual pathway. It is not immediately resolved by the correction of refractive error. Strabismus develops in approximately 5% to 8% of the general population. The aim of treatment for amblyopia is to obtain the best possible level of vision in the amblyopic eye. Different treatment options were examined within the review.
OBJECTIVES
By reviewing the available evidence we wanted to establish the most effective treatment for strabismic amblyopia. In particular this review aimed to examine the impact of conventional occlusion therapy for strabismic amblyopia and to analyse the role of partial occlusion and optical penalisation for strabismic amblyopia.
SEARCH METHODS
We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2013, Issue 12), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to January 2014), EMBASE (January 1980 to January 2014), Latin American and Caribbean Health Sciences Literature Database (LILACS) (January 1982 to January 2014), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 January 2014.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) for the treatment of strabismic amblyopia including participants of any age.
DATA COLLECTION AND ANALYSIS
Two authors working independently extracted and entered data into Review Manager 5 and then independently checked the data for errors.
MAIN RESULTS
We included three RCTs in this review. The studies reported mean logMAR visual acuity achieved. Mean difference in visual acuity was calculated. When comparing conventional part-time occlusion (with any necessary glasses), PEDIG 2006 reported that this treatment was more beneficial than glasses alone for strabismic amblyopia; the mean difference between groups was -0.18 LogMAR (statistically significant 95% confidence interval (CI) -0.32 to -0.04). Supplementing occlusion therapy with near activities may produce a better visual outcome compared to non-near activities after four weeks of treatment (PEDIG 2005). The results of the pilot study showed mean difference between groups was -0.17 LogMAR (95% CI -0.53 to 0.19). Results from a larger RCT (PEDIG 2008) are now available, showing that supplementing occlusion therapy with near activities may produce a better visual outcome after eight weeks of treatment; the mean difference between groups was -0.02 LogMAR (95% CI -0.10 to 0.06). One further article ia awaiting assessment as in its current format there is insufficient information to include (Alotaibi 2012).
AUTHORS' CONCLUSIONS
Occlusion, whilst wearing necessary refractive correction, appears to be more effective than refractive correction alone in the treatment of strabismic amblyopia. The benefit of combining near activities with occlusion is unproven. No RCTs were found that assessed the role of either partial occlusion or optical penalisation to refractive correction for strabismic amblyopia.
Topics: Amblyopia; Child; Child, Preschool; Eyeglasses; Humans; Randomized Controlled Trials as Topic; Sensory Deprivation; Strabismus; Visual Acuity
PubMed: 25051925
DOI: 10.1002/14651858.CD006461.pub4 -
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 -
American Family Physician Feb 2007Amblyopia, a decrease in visual acuity, is a major public health problem with a prevalence of 1 to 4 percent in the United States. It is thought to develop early in life... (Review)
Review
Amblyopia, a decrease in visual acuity, is a major public health problem with a prevalence of 1 to 4 percent in the United States. It is thought to develop early in life during the critical period of visual development. Early recognition of amblyogenic risk factors such as strabismus, refractive errors, and anatomic obstructions can facilitate early treatment and increase the chance for recovery of visual acuity. Multiple medical organizations endorse screening for visual abnormalities in children and young adults, yet only 20 percent of school-age children have routine vision screening examinations. Any child with a visual acuity in either eye of 20/40 or worse at age three to five years or 20/30 or worse at age six years or older, or a two-line difference in acuity between eyes, should be referred to an ophthalmologist for further evaluation and definitive therapy. Treatment is started at the time of diagnosis and depends on the etiology. Treatment options for children with strabismus include patching and atropine drops. Children with refractive errors should be prescribed corrective lenses. Corneal lesions, cataracts, and ptosis require surgery. The success of therapy is highly dependent on treatment compliance. Patients and their parents should be educated about the need for regular follow-up and the risk of permanent vision loss.
Topics: Amblyopia; Child; Child, Preschool; Humans; Infant; Infant, Newborn
PubMed: 17304867
DOI: No ID Found