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The Value of Screening for Amblyopia Revisited

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Pediatric Ophthalmology, Neuro-Ophthalmology, Genetics

Part of the book series: Essentials in Ophthalmology ((ESSENTIALS))

Core Messages

  • Vision screening for children may be considered in terms of detection of amblyopia, strabismus, and/or refractive error. Variations exist within and between countries regarding vision screening for children in terms of program content, referral criteria, and personnel. Recommendations state pre-school vision screening programs be conducted by orthoptists or by professionals trained and supported by orthoptists.

  • The justifications of vision screening for children include an increased risk of blindness to the healthy eye as a result of injury or disease in adults with amblyopia. An increased risk of blindness is present as the non-amblyopic eye of an amblyope may become diseased or injured.

  • A recent report found that screening for amblyopia could not be considered as cost-effective, but acknowledged that much uncertainty exists surrounding the short- and long-term implications of the condition(s). Further research is needed to provide such evidence.

  • Treatment of amblyopia associated with refractive error should incorporate a period of observation with glasses-wear alone to allow for “refractive adaptation” (also known as “optical treatment of amblyopia”). Improvements in visual acuity (VA) can occur up to and beyond 20 weeks after glasses are prescribed. Most improvement occurs in weeks 4–12. In some cases, further amblyopia therapy may not be required.

  • Children who undergo amblyopia therapy at an early age have been found to respond more quickly to occlusion than older children, and require less occlusion in total. There is evidence to suggest that successful treatment of children aged over 7 years can be achieved in cases of anisometropic, strabismic, and mixed etiology amblyopia.

  • Atropine has been found to be as effective as patching in the treatment of both moderate and severe amblyopia.

  • Recurrence of amblyopia may occur following treatment, with reported rates of 7–27%. Factors influencing recurrence include age of the child at cessation of treatment, VA at the time of cessation of treatment, and the type of amblyopia that is present.

  • Reported health-related quality of life (HRQoL) implications of amblyopia include the impact of the condition upon stereoacuity; fine motor skills; reading speed; and interpersonal relationships.

  • The reported HRQoL implications of strabismus are related to physical appearance, particularly upon self-image and interpersonal relationships. Surgical correction of strabismus has been reported to improve HRQoL.

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Authors and Affiliations

  1. Health Economics and Decision Science, CHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK

    Jill Carlton

  2. Leeds Institute of Health Sciences, University of Leeds, Room 1.26, 6 Charles Thackrah Building, 101 Clarendon Road, Leeds, LS2 9LJ, UK

    Carolyn Czoski-Murray

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  1. Jill Carlton
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Editors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Justus-Liebig-University UKGM GmbH Giessen Campus, Friedrichstraße 18, Giessen, 35392, Germany

    Birgit Lorenz (Professor of Ophthalmology) (Professor of Ophthalmology)

  2. Department of Ophthalmology, Professor of Ophthalmology and Neurology Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Michael C. Brodsky

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Carlton, J., Czoski-Murray, C. (2010). The Value of Screening for Amblyopia Revisited. In: Lorenz, B., Brodsky, M.C. (eds) Pediatric Ophthalmology, Neuro-Ophthalmology, Genetics. Essentials in Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-85851-5_8

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  • DOI: https://doi.org/10.1007/978-3-540-85851-5_8

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