Prevalence Of Amblyopia Research Articles

Colour vision deficiency is associated with increased prevalence of amblyopia, strabismus and ametropia: a large population study

AimsTo examine the association between colour vision deficiency (CVD) and other ophthalmic disorders including amblyopia, strabismus and ametropia in a large population study.MethodsThe retrospective, cross-sectional study included 916 388 Israeli...

Clinical ocular prediction model of postoperative ametropic amblyopia in patients with congenital ectopia lentis.

Despite prompt and appropriate surgical management, a considerable proportion of patients with congenital ectopia lentis (CEL) suffer from postoperative ametropic amblyopia. To predict and identify at-risk patients early, and ensure timely amblyopia treatment, we conducted a thorough investigation into the onset and progression patterns of postoperative amblyopia in patients with CEL. Moreover, an ocular prediction model was constructed for amblyopia. In this prospective cohort study, amblyopia analysis was conducted to reveal the prevalence of postoperative amblyopia at different time points of follow-up. Comparative analysis and logistic regression analysis were performed for the development of an amblyopia prediction model. Receiver Operating Characteristic (ROC) analysis, calibration plots, and decision curve analysis (DCA) were used to evaluate the performance of the model. A nomogram was created to determine the probability of postoperative amblyopia. Amblyopia was diagnosed according to the most recent edition of the Amblyopia Preferred Practice Pattern. A total of 889 eyes from 677 patients operated for CEL were enrolled in this study. In the pediatric cohort, the prevalence of amblyopia showed a decreasing trend with follow-up time from 1 month to 3.5 years. A prediction model based on preoperative best-corrected visual acuity (BCVA) and cardiac phenotype was established to predict postoperative amblyopia. For effective individual prediction, a nomogram was created. With great calibration, discrimination, and clinical usefulness, the prediction model demonstrated good performance. The findings underscore that the prevalence of ametropic amblyopia in pediatric CEL patients who underwent lens surgery exhibited a marked decline over time. The prediction model established with preoperative BCVA and cardiac phenotype can provide accurate and individualized predictions of postoperative amblyopia, and it has the potential to assist ophthalmologists in rapidly identifying high-risk patients.

Patterns of refractive errors and visual function in school-going children in South Africa

Background: Uncorrected refractive error is the most significant contributor of VI in children and is usually detected through vision screenings or scheduled eye and vision examinations conducted among school children.Aim: To describe patterns of refractive errors (RE), visual function and amblyopia in school-going children.Setting: Mankweng, Polokwane, South Africa.Methods: Retrospective chart reviews were conducted on 837 clinical record cards of children attending selected schools and who were screened between 2019 and 2021 at the University of Limpopo Optometry clinic. Purposive sampling was used to sample the clinical record cards.Results: About 134 children (16%) reported blurred vision, 197 (23.5%) failed distance visual acuity screening, while 173 (20.7%) had RE. Myopia among 168 (9.6%) children was the most common RE, followed by astigmatism and hyperopia at 60 (4.70%) and 28 (4.4%), respectively. Furthermore, 14 (1.7%) children had anisometropia. Amblyopia, colour vision deficiency and contrast sensitivity were also detected at prevalence rates of 4.4%, 9.8% and 8.2%, respectively.Conclusion: Vision screenings and regular comprehensive eye examinations are commonly conducted to detect and manage REs to prevent or delay the onset of amblyopia and strabismus. Children had a high prevalence of RE and amblyopia, which is similar to global estimates.Contribution: To describe the pattern of REs, amblyopia and visual function, which is critical to understand the prevalence of amblyopia and associated conditions. Knowing the patterns of these conditions may provide an impetus for the implementation of strategies such as vision screenings and vision examinations in schools.

Prevalence of Amblyogenic Risk Factors Among School Children in India Using the Spot Vision Screener.

Amblyopia is a common cause of preventable visual impairment in children, affecting 1% to 6% globally. This study assesses amblyopia prevalence and risk factors among school children in rural Telangana, India, using the Spot Vision Screener (Welch Allyn, Inc., Skaneateles Falls, New York, USA), a portable, noninvasive device recommended for automated vision screening. A cross-sectional study was conducted on 714 schoolchildren aged 5-10 years. Screening was performed using the Spot Vision Screener, evaluating refractive errors, ocular alignment, and other amblyopia risk factors. Children identified with potential amblyogenic factors were referred for comprehensive ophthalmological evaluation to confirm diagnosis. Out of 714 children screened, 84 were referred by the Spot Vision Screener for further evaluation. Subsequent examination by ophthalmologists confirmed amblyopia in 65 children, resulting in a prevalence of 9.10%. Myopic refractive error was the most prevalent (69.23%), followed by astigmatism (21.53%) and hypermetropia (9.23%) among amblyopia cases. The Spot Vision Screener proved to be a reliable tool for identifying amblyopia risk factors in school children, facilitating early detection and referral for appropriate management. This study underscores the importance of implementing effective vision screening programs in rural settings to mitigate preventable childhood blindness.

Vision screening and refraction of Greenlandic schoolchildren.

To estimate the prevalence of amblyopia and refractive errors among 6-year-old children in Greenland and to assess the impact of incorporating autorefraction, stereoacuity and near visual acuity testing into vision screening. In this cross-sectional study, 517 children (238 girls and 279 boys) from 21 locations in Greenland were screened using HOTV charts for distance and near visual acuity (VA), stereoacuity test and non-cycloplegic autorefraction. Referral criteria for further ophthalmological examination included a VA of ≥0.2 logMAR on the worse-seeing eye or an interocular VA difference of ≥2 lines. Initial screening identified amblyopia (defined as VA of ≥0.3 logMAR) in 7% (unilateral) and 3% (bilateral) of children. However, subsequent ophthalmological examinations confirmed amblyopia in under 40% of referrals. Significant interocular VA differences were found in 9%. The prevalence of refractive errors at the screening was 3% for myopia (≤-0.5 dioptres), 10% for hyperopia (>+2.0 dioptres) and 14% for astigmatism (≤-1.00 dioptres), while the corresponding prevalences at the ophthalmological examination were 4% for myopia, 8% for hyperopia and 6% for astigmatism. Combining screening measurements increased the positive predictive values, thereby enhancing screening accuracy. Specifically, the incorporation of autorefraction or stereoacuity with distance VA demonstrated to be the most effective combination. Six percent of the children were prescribed glasses after the screening procedure. This study provides the first visual profile of Greenlandic schoolchildren. Incorporating autorefraction, stereoacuity and near visual acuity in vision screenings enhanced the efficacy of detection of vision anomalies. Although this may lead to more false positives, accurate screening is crucial in regions with limited ophthalmological resources.

How does the Surgical Repair of Ptosis Impact Refractive Error?

ABSTRACT Purpose To identify a correlation between the degree of congenital ptosis and levels of refractive error, visual stimulus deprivation and anisometropic amblyopia, and any improvement with surgical intervention. Methods A prospective investigation of 30 patients aged 3 months to 8 years, with a diagnosis of unilateral or bilateral congenital ptosis. A full orthoptic assessment and cycloplegic refraction were performed and patients requiring surgical intervention for ptosis were at surgeon discretion. Results The mean age at presentation was 27.1 months. The prevalence of amblyopia ranged from 19 to 29%. There was no significant difference in the levels of astigmatism throughout the follow-up period between patients who underwent surgical intervention and who did not. There was a significant improvement in the visual acuity of the affected eye (p = .03) and both eyes open (p = .02), in patients who did not undergo surgery. This was then repeated on patients who underwent surgical intervention which showed no significant difference in the affected eye or both eyes open; p = .27, p = .32, respectively. Conclusion There is no significant change in the levels of astigmatism in both patients who underwent surgery and those who did not. Conservative management of congenital ptosis, while counterintuitive, proves not to deleteriously affect the visual potential of these patients.

Assessment of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah

Background and AimRefractive errors, amblyopia, strabismus, and low vision are more common among children with hearing impairments in comparison with their hearing peers. Neglecting visual disorders can pose educational and social problems for these children. The present study aimed to assess the prevalence of refractive errors, amblyopia, strabismus, and low vision among hearing-impaired and deaf students in Kermanshah.Materials and methodsA total of 79 deaf and hearing impaired students within the age range of 7–20 years (mean age of 15.01 ± 2.72) underwent optometric examinations, including autorefractometry, retinoscopy, ophthalmoscopy, slit lamp, visual acuity measurement, and cover-uncover test. Those who needed further evaluation were referred to the Ophthalmology Clinic of Imam Khomeini Hospital.ResultsRegarding the prevalence of refractive errors, 32 (40.5%) subjects had one or a combination of refractive errors, the most common of which was astigmatism (36.7%), followed by amblyopia (15.1%). The most common type of strabismus was latent strabismus (heterophoria) (88.6%), followed by exophoria (81%). Moreover, 3 (3.7%) cases had nystagmus. A significant difference was observed between the prevalence of amblyopia and the degree of hearing loss (P = 0.026), and no significant difference was detected in other cases.ConclusionAs evidenced by the obtained results, refractive errors, amblyopia, strabismus, and low vision are more prevalent among deaf and hearing-impaired children compared to normal children because deaf and hearing-impaired children are not able to convey their vision problems and need to compensate for their poor hearing with an enhanced sense of sight, inattention to these disorders can present these children with serious educational and social problems. Therefore, eye screening examinations are of paramount importance in deaf and hearing-impaired children.

Clinical characteristics and surgical outcomes in patients with superior oblique muscle palsy: a retrospective study on 1057 patients

BackgroundTo evaluate the clinical findings of patients with SOP who underwent surgery.MethodsThis historical cohort study was performed on 1057 SOP patients managed with surgery in Farabi Hospital, Iran, from 2011 to 2022.ResultsThere were 990 (93.7%) patients with unilateral SOP with the mean age of 21.8 ± 14.8 years. Of these, 715 patients (72.2%) were diagnosed with congenital SOP, and 275 patients (27.8%) had acquired SOP (P < 0.001). In contrast, 67 (6.3%) patients were diagnosed with bilateral SOP, with the mean age of 19.4 ± 15.6 years. Among these, 18 cases exhibited the masked type. The mean angle of vertical deviation in primary position at far in unilateral and bilateral cases was 15.6 ± 8.3 and 13.3 ± 9.1 △, respectively (P < 0.001). In unilateral cases, abnormal head posture (AHP) was detected in 847 (85.5%) patients and 12 (1.2%) had paradoxical AHP. Amblyopia was found in 89 (9.9%) unilateral and 7 (10.3%) bilateral cases. Solitary inferior oblique myectomy, was the most common surgery in both unilateral (n = 756, 77.1%) and bilateral (n = 35, 52.2%) patients. The second surgery was performed for 84 (8.6%) unilateral and 33 (49.3%) bilateral cases (P < 0.001). The prevalence of amblyopia and the mean angle of horizontal deviation were significantly higher in patients who needed more than one surgery (all P < 0.05).ConclusionCongenital SOP was more than twice as frequent as acquired SOP and about 90% of unilateral and 50% of bilateral cases were managed with one surgery. Amblyopia and significant horizontal deviation were the most important factors for reoperation.Trial registrationThe Institutional Review Board approval was obtained from the Tehran University of Medical Sciences (IR.TUMS.FNM.REC.1400.012) and this study adhered to the tenets of the Declaration of Helsinki and HIPAA.

Pattern of Refractive Error among Amblyopic Children at tertiary referral hospital of Ahmedabad, Gujarat.

Introduction: Amblyopia is one of the common causes of preventable uniocular or binocular vision loss in children. Timely diagnosis and management of amblyopia is crucial. If corrective measures are not taken in time it becomes permanent. Aim: To study the various types of refractive errors in amblyopic children aged 5-18 years in tertiary eye hospital. Materials and Methods: Retrospective cross –sectional study was carried out in the tertiary eye care hospital. All the children attending the ophthalmology OPD during January2021 to January 2023 were enrolled. All underwent detailed ophthalmic evaluation. After post mydriatic test, children with difference of two lines or more in visual acuity on Snellen chart were taken and detailed ophthalmic evaluation done. Results: The prevalence of amblyopia was 6.2% (n=48) with male dominant of 62.5% (n=30), while female was 37.5% (n=18). In types of Amblyopia, most common was simple Hypermetropic of 42% (n=20) followed by simple myopic and hypertropic Astigmatism 19% (n=9) in each. The Anisometropia Amblyopia was in 12% (n=6), while myopic astigmatism in 8%(n=4). The 69%(n=33) was binocular while 31% (n=15) was uniocular amblyopia. Conclusion: The Refractive errors are treatable and preventable cause of amblyopia. Timely diagnosis and proper treatments like spectacles, contact lenses, patching and active vision exercises, we can treat Amblyopia and prevent the psychosocial, economical loss in adult life. Keywords: Myopia, Hypermetropia, Anisometropia, Astigmatism

Prevalence and characteristics of amblyopia, strabismus, and refractive errors among patients aged 3–16 years in Shanghai, China: a hospital-based population study

BackgroundFunctional visual impairments in children are primarily caused by amblyopia or strabismus. This study aimed to determine the prevalence and clinical profile of amblyopia and strabismus among individuals aged 3–16 years in Shanghai, China.MethodsFrom February 2023 to February 2024, this hospital-based, cross-sectional study included data of children who visited the Ophthalmology Department of Shanghai General Hospital. Comprehensive ocular examinations included visual acuity measurement after cycloplegic refraction, slit lamp examination, cover test, and dilated fundus examination. Descriptive statistics were performed to estimate the proportion and clinical characteristics of amblyopia and strabismus.ResultsA total of 920 children were enrolled in our study. Among them, 223 (24.24%) children were identified as amblyopia. Unilateral amblyopia occupied 57.85%, and bilateral amblyopia occupied 42.15%. Most participants were within the age range of 5–10 years (75.97% for unilateral amblyopia, and 70.21% for bilateral amblyopia). Anisometropia was the primary cause of unilateral amblyopia (68.99%). Most amblyopic children have high hyperopia (38.76% for unilateral amblyopia, and 39.89% for bilateral amblyopia). 30 (3.26%) children were diagnosed with strabismus, and 19 (63.3%) of them were aged 5–10 years. Seven of the children had both strabismus and amblyopia.ConclusionThe proportion of patients with amblyopia and strabismus was determined as 24.24% and 3.26% in our study. Anisometropia was the leading cause of unilateral amblyopia, whereas high hyperopia was a crucial refractive error in the amblyopic population. These findings shed light on further longitudinal studies targeting the age-related changes in amblyopia, strabismus and refraction errors. Therefore, efforts should be made to manage uncorrected refractive errors, amblyopia, and strabismus among children in Shanghai.

Continued care and provision of glasses are necessary to improve visual and academic outcomes in children: Experience from a cluster-randomized controlled trial of school-based vision screening

ObjectiveTo assess the effectiveness of a kindergarten vision screening program by randomly assigning schools to receive or not receive vision screening, then following up 1.5 years later.MethodsFifty high-needs elementary schools were randomly assigned to participate or not in a vision screening program for children in senior kindergarten (SK; age 5‒6 years). When the children were in Grade 2 (age 6‒7 years), vision screening was conducted at all 50 schools.ResultsContrary to expectations, screened and non-screened schools did not differ in the prevalence of suspected amblyopia in Grade 2 (8.6% vs. 7.5%, p = 0.10), nor prevalence of other visual problems such as astigmatism (45.1% vs. 47.1%, p = 0.51). There was also no difference between screened and non-screened schools in academic outcomes such as the proportion of children below grade level in reading (33% vs. 29%) or math (44% vs. 38%) (p = 0.86). However, more children were wearing glasses in screened than in non-screened schools (10.2% vs. 7.8%, p = 0.05), and more children reported their glasses as missing or broken (8.3% vs. 4.7%, p = 0.01), suggesting that SK screening had identified successfully those in need of glasses. Examination of individual results revealed that 72% of children diagnosed and treated for amblyopia in SK no longer had amblyopia in Grade 2.ConclusionThe prevalence of amblyopia and other visual problems was not reduced in Grade 2 by our SK vision screening program, perhaps because of poor treatment compliance and high attrition. The results suggest that a single screening intervention is insufficient to reduce visual problems among young children. However, the data from individuals with amblyopia suggest that continuing vision care and access to glasses benefits children, especially children from lower socioeconomic class.

Treatment outcome in refractive accommodative esotropia

Background Accommodative esotropia (ET) usually presents in preschool years. It is often intermittent, and the deviation is typically eliminated by controlling the accommodative effort with optical correction of hypermetropia. Objective The aim of this study was to document the clinical features and to assess the functional outcome in patients with refractive accommodative esotropia (RAE) in terms of amblyopia and binocular vision and to analyze the possible risk factors involving the development of amblyopia. Patients and methods We retrospectively reviewed the records of 60 patients diagnosed with fully accommodative esotropia (FAET). Multiple parameters were reviewed, including age of onset, age of initiation of treatment, initial and final cycloplegic refraction, distance and near deviation with and without glasses, stereoacuity, presence of anisometropia, and change in hyperopia. Results The mean age of onset and age of initiation of treatment were 2.53±1.42 and 2.73±1.25 years, respectively. The mean spherical equivalent refraction at the initial visit was +5.36±1.48 diopters (D) in the right eyes and +5.62±1.43 D in the left eyes. Anisometropia was present in 33.33% of the patients. Fusion was achieved in 90% of the patients, with 38 (63.33%) patients having stereopsis ranging from 40–100 sec/arc and 22 (36.67%) having stereopsis between 100 and 200 sec/arc with the Titmus fly test. Amblyopia was reduced from 50% to 16.67%. Anisometropia was found to be the only statistically significant risk factor for the development of amblyopia (P&lt;0.001). Hypermetropia showed a tendency either to remain stable or to increase over the first seven years of life and then tended to decrease. Conclusion Most of the patients with FAET have an excellent outcome in terms of visual acuity and binocular vision. Amblyopia is common among patients with RAE and the current management strategies resulted in marked reduction in the prevalence of amblyopia.

Cost-effectiveness of screening for amblyopia among kindergarten children in China

ObjectiveCurrent cost-effectiveness analyses of amblyopia screening are mainly from western countries. It remains unclear whether it is cost-effective to implement a preschool amblyopia screening programme in China. Our study aimed to evaluate the cost-effectiveness of a hypothetical kindergarten-based amblyopia screening versus non-screening among 3-year-old children. MethodsWe developed a decision tree combined with a Markov model to compare the cost and effectiveness of screening versus non-screening for 3-year-old children from a third-party payment perspective. The primary outcomes were quality-adjusted life years (QALYs) and the incremental cost-effectiveness ratio (ICER). Costs were obtained from expert opinions in different regions of China. Transition probabilities and health utilities were mainly based on published literature and open sources. Sensitivity analyses were performed to assess the impact of parameters’ uncertainty on results. ResultsBase-case analysis demonstrated that the ICER of screening versus non-screening was $17,466/QALY, well below the WTP threshold ($38,223/QALY) for China. One-way sensitivity analysis showed that the prevalence of amblyopia, the transition probability per year from untreated amblyopia to healthy, and the discount rate were the top three factors. The likelihood of cost-effectiveness of screening compared with non-screening was 92.56%, according to probabilistic sensitivity analysis. Scenario analysis also indicated that ICER was lower than the WTP threshold even if the time horizon was shortened or the screening was delayed to the age of 4 or 5. ConclusionsAmblyopia screening could be considered a cost-effective strategy compared to non-screening for 3-year-old children in China. Screening for children at the age of 4 or 5 may even yield better results.

Amblyogenic risk factors and validity of vision screening using spot-screener among kindergarten children in Qassim region, Saudi Arabia.

The purpose of the study was to present the outcomes of vision and amblyogenic risk factor (ARF) screening in kindergarten children in the Qassim region, Saudi Arabia. In this cross-sectional study, an optometrist conducted first-level screening in a kindergarten using a spot screener (Welch Allyn) in 2023. Refractive status and ocular alignment were evaluated. The visual acuity of each eye was measured. Those who failed the first screening or had impaired vision were re-evaluated at the second level of screening by an optometrist and pediatric ophthalmologist. Those who failed the screening in Kindergarten were referred to a pediatric ophthalmology clinic for confirmation and management (third level of screening). We screened 222 children (mean age: 5.9 ± 0.4 years, 111 boys). A total of 59 (26.6%) children failed the spot vision screening test. A vision screening test by an optometrist identified 58 (26.1%) children with impaired vision. Refractive errors (REs) for children who failed the spot screener included hyperopia in 4 (6.7%) children, high myopia (>6.00 D) in 2 (3.4%) children, and astigmatism in 53 (89.83%) children. Compared to the evaluation by optometrists and pediatric ophthalmologists at KGs, spot screening had 0.845 sensitivity and 0.939 specificity. Validity parameters differed for RE, vision impairment, amblyopia, and strabismus. Seventy-one (31.98%) children were referred for third-level screening, but only 32 (44.4%) children attended, and among them, the prevalence of amblyopia was 25%. The high prevalence of amblyopia and undetected ARFs necessitate establishing annual vision screening among 3- to 5-year-old children in the study area.

Prevalence and causes of ocular disorders and visual impairment among preterm children in Ethiopia

ObjectiveThe aim of this study was to determine the prevalence, causes of ocular disorders and visual impairment among preterm children previously admitted to neonatal intensive care units in Addis Ababa,...

Efficacy of Worth 4 Dot Test and Vertical prism dissociation Test in Screening of Amblyopia for School Going Children.

Introduction: Amblyopia is reduction of best corrected visual acuity in one or both eyes that cannot exclusively be attributed to structural abnormality of the eye. It can be better treated if diagnosed early in life. Fixation preference is assessed in Vertical prism dissociation test (VPDT) to predict amblyopia while in Worth 4 dot test (W4DT) degree of suppression is detected which tell us the presence of amblyopia.&#x0D; Objective: The objectives of this study were mainly, to assess the efficacy of Worth 4 dot test and Vertical prism dissociation test in screening of amblyopia in School going children and to screen the prevalence of amblyopia.&#x0D; Methods: It was a Descriptive cross-sectional study conducted from October 2020 to June 2021 at three Government Schools of Faisalabad, Pakistan. Non-probability random sampling Technique was used to screen out 400 subjects. All subjects were equally screened out with the help of VPDT and W4D test. Data was analyzed through chi-square and cross tabulation by using SPSS software version 20. Both VPD test and W4D test were performed in which fixation pattern and suppression were documented on self-designed proforma.&#x0D; Results: There was a good agreement between qualitative measures of fixation pattern with VPDT and suppression with W4DT for the clinical determination of amblyopia (p &lt; 0.005).&#x0D; Conclusion: This study concluded that the prevalence of amblyopia was 8% in school going children and there was significant relationship in success rates and reliability of vertical prism dissociation test and worth four dot test in screening of amblyopia (p=0.00).

Do Socioeconomic Inequalities Exist Within Ophthalmology and Orthoptics in the UK?: A Scoping Review.

It is well documented that socioeconomic disadvantage adversely affects general health and ocular health worldwide. Within orthoptics, while clinicians recognise a relationship between socioeconomic situation and treatment outcome, no previous literature review was found to address this issue. Neither was a UK-specific literature review found to address the same issue for ophthalmology as a whole. This literature review evaluates evidence for an association between socioeconomic situation and ophthalmic/orthoptic conditions and their treatment outcomes, specifically within the UK. Keyword searches were conducted on Google Scholar and the University of Liverpool library catalogue. Results for the main analyses were limited to full papers, specific to the UK, written in English. Literature was only included from pre-2000 if more recent evidence was insufficient. There is evidence of socioeconomic disadvantage being associated with the following: reduced visual acuity; reduced attendance at diabetic retinopathy screening appointments; and delayed presentation of glaucoma, cataracts, and diabetic retinopathy. However, evidence linking socioeconomic disadvantage to AMD is mixed. There is limited evidence of the increased prevalence of amblyopia and subsequent barriers to its treatment for socioeconomically underserved children. There is also evidence of a reduction in quality of life for socioeconomically underserved adults with strabismus. Health inequalities within ophthalmology and orthoptics are reported, but with confounding results for some conditions. Further research should explore the reasons behind the inequalities that are found and identify methods of reducing them.

Prevalence of anisometropia and its associated factors in school-age children

ABSTRACT Purpose To determine the prevalence of anisometropia and the associated demographic and biometric risk factors in children. Methods This cross-sectional study was conducted on the elementary school children of Shahroud, east of Iran, in 2015. All rural students were recruited, while multistage cluster sampling was used to select the students in urban areas. All children underwent optometric examinations including the measurement of uncorrected and corrected visual acuity, autorefraction, and subjective refraction with cycloplegia. Biometric components were measured using the Allegro Biograph. Myopia and hyperopia were defined as a spherical equivalent ≤−0.5 and ≥ +2.00 diopter, respectively. Students with a history of ocular trauma or lack of cycloplegic refraction at least in one eye were excluded from the study. Results Of 6624 selected children, 5620 participated in the study. After applying the exclusion criteria, the data of 5357 students (boys: 52.8%, n = 2834) were analyzed. The mean age of the subjects was 9.2 ± 1.7 years (range: 6–12 years). The prevalence of anisometropia ≥ 1 D was 1.1% (95% CI: 0.8 to 1.4) in all children, 1.0% (95% CI: 0.7–1.3) in boys, 1.3% (95% CI: 0.8–1.7) in girls, 1.1% (95% CI: 0.8–1.4) in urban children, and 1.4% (95% CI: 0.5–2.3) in rural children. The prevalence of anisometropia was 8.8% (95% CI: 5.3–12.2) in myopic and 5.7% (95% CI: 2.8–8.5) in hyperopic children. Axial length asymmetry (OR = 40.9; 95%CI: 10.2–164.1), myopia (OR = 17.9; 95% CI: 9.4–33.9), and hyperopia (OR = 10.1; 95% CI: (5.1–19.7) were associated with anisometropia in multiple logistic regression model. More anisometropia was associated with more severe amblyopia. The odds of amblyopia (OR = 82.3: 38.2-177-3) and strabismus (OR = 17.6: 5.5–56.4) were significantly higher in anisometropic children. The prevalence of amblyopia was 21.7% in children with myopic anisometropia ≥ 3D, 66.7% in children with hyperopic anisometropia ≥ 3D, and 100% in cases with antimetropia ≥ 3D. Conclusion The prevalence of anisometropia was low in Iranian school children. However, a high percentage of anisometropic students had amblyopia and strabismus. Axial length was the most important biometric component associated with anisometropia.

The prevalence of functional amblyopia and its related risk factors in preschool children in North-Eastern Iran.

Purpose was to determine the prevalence of amblyopia and its related risk factors in children aged 3-6 years in Bojnurd, north-eastern Iran. In this cross-sectional study, from 12,331 children aged 3-6 in Bojnurd, 6600 children participated in annual amblyopic screening program and among them, around 1100 suspected cases were referred for full ophthalmic examinations. Measurement of visual acuity, cycloplegic refraction, subjective refraction, and cover test were performed for all participants. Amblyopia was defined as CDVA of 0.2 LogMar or less in each eye or 2-line difference or more in best-corrected visual acuity between two eyes. The prevalence of amblyopia was estimated 0.95% (95% confidence interval [CI]: 0.73%-1.2%). There was no relationship between amblyopia with age and genders. Most amblyopic children were hyperopic (61.9%; 95% CI: 48.7-73.8). Strabismus was found in 17.4% of amblyopic patients (95% CI: 9.05%-29.09%). Approximately half of the amblyopic children were anisometropic (55.5%; 95% CI: 42.40%-68.08%). The most common type of amblyopia was anisohyperopic (55.56%; 95% CI: 42.5%-67.5%). The prevalence of bilateral amblyopia was more than unilateral amblyopia. The assessment of data showed that hyperopia, astigmatism, and anisometropia were the most common causes of amblyopia in this study. The prevalence of amblyopia was estimated about 1% in north-eastern Iran. Our study indicated a valuable information around the effect of refractive error and anisometropia on amblyopia which could be helpful in designing a comprehensive vision screening program for preschool children.

Unleashing the power of Virtual Reality to manage LAZY EYE-A silent public health problem: A case study from India

Amblyopia, also known as "lazy eye," is a childhood vision disorder characterized by impaired coordination between the brain and the eye, resulting in decreased vision in one eye. It is not caused by any structural abnormalities in the eye but rather by a lack of effective coordination between the eye and brain during the crucial period of visual development in early childhood.(1) Amblyopia is a significant global public health issue, with an estimated prevalence of 1-5% of the global population according to the World Health Organization (WHO). Developing countries face a higher burden of amblyopia due to limited access to early diagnosis and treatment. If left untreated, amblyopia can result in permanent vision loss and impairment, negatively impacting an individual's quality of life, educational achievements, and career prospects.(1) A 2017 study explored the prevalence and impact of amblyopia and strabismus in Indian children. The study found a prevalence rate of 1.67% for amblyopia among children aged 5-15 years, with a higher occurrence in rural areas compared to urban areas.(2) In another study conducted by Gupta et al. found the percentage of amblyopia was 8.6% (n=31) among 5-15 years children in uttrakhand.(3) Another study conducted by Ganekal et al. revealed the prevalence of amblyopia was 1.1% (n?=?44) among 5-15 years of students.(4) The research emphasized the importance of enhanced awareness, early detection, and improved access to suitable treatment options to alleviate the burden of amblyopia in India. Furthermore, the All India Ophthalmological Society (AIOS) conducted a study in 2019 titled "AIOS Guidelines for Amblyopia Management." This study aimed to provide evidence-based guidelines for managing amblyopia in India. It highlighted the lack of awareness and limited availability of eye care services in certain regions, leading to delayed diagnosis and treatment of amblyopia. The guidelines emphasized the significance of early screening, timely intervention, and appropriate treatment approaches to prevent long-term visual impairment in children.(5)