Amblyopia
BMJ 2015; 351 doi: https://doi.org/10.1136/bmj.h5811 (Published 12 November 2015) Cite this as: BMJ 2015;351:h5811- Joanna M Jefferis, ophthalmology trainee1,
- Alan J Connor, paediatric ophthalmology fellow23,
- Michael P Clarke, consultant paediatric ophthalmologist3
- 1Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, UK
- 2Department of Ophthalmology, Hospital for Sick Children, Toronto, Canada
- 3Newcastle Eye Centre, Newcastle upon Tyne Hospitals NHS Foundation Trust, Royal Victoria Infirmary, Newcastle Upon Tyne NE1 4LP, UK
- Correspondence to: J M Jefferis jojefferis{at}doctors.org.uk
What you need to know
Amblyopia is a form of cortical visual impairment which can result from any condition that prevents normal visual stimulation in the first few years of life
Most amblyopia arises as a result of a difference in refractive errors between the two eyes (anisometropia), ocular misalignment (strabismus or squint), or a combination of these two factors
Most amblyopia is unilateral and, as such, may go unnoticed by children and parents until detected at screening
In the UK, orthoptic-led vision screening is recommended for all children at school entry age (4-5 years)
There are two phases in amblyopia treatment: (1) optical correction of any refractive error for a period of 12-16 weeks, which will be the only treatment required in 25% of children, and (2) occlusion or atropine therapy
Occlusion therapy with patches in a 4 year old child would typically be prescribed for 3-6 hours a day for a period of 3 months in the first instance
Atropine eye drops can be used in children older than 3 years as an alternative to patching, with 1% atropine once daily at the weekends an effective dose
What is amblyopia?
Amblyopia is a form of cortical visual impairment. It results from abnormal visual development in childhood, secondary to another pathological process, and can lead to permanent, usually monocular, reduced vision.1 It affects a variety of visual functions (see table 1⇓). The term “lazy eye” is often used, but amblyopia should be differentiated from strabismus (squint). These conditions may coexist, but the treatments should be considered separately.
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Sources and selection criteria
We searched Medline from 1950 to 2015 using a broad search strategy with appropriate descriptors and key words: amblyopia, vision screening, occlusion, atropine, or a combination of …
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