Summary
Definition
History and exam
Other diagnostic factors
- asymptomatic
- subnormal visual acuity for age in 1 or both eyes
- asymmetric corneal light reflex
- unequal behavioral response to alternate eye occlusion
- abnormal cover/uncover testing
- blurred vision
- eye strain
- congenital nystagmus
- abnormal pupil exam
- abnormal external eye exam
Risk factors
- age <9 years
- prematurity
- FHx of amblyopia or strabismus
- strabismus (misalignment of the eyes)
- hyperopic anisometropia (farsightedness with unequal refractive error between the 2 eyes) of >+1.50 diopter
- myopic anisometropia
- astigmatism (cylindrical, rather than spherical, defocus of the eye) >2.00 diopter
- hyperopia >+4.50 diopter
- myopia >-3.00 diopter
- opacity in the cornea, anterior chamber, lens, vitreous, or retinal surface
- severe ptosis or prolonged occlusion of 1 or both eyes
- developmental delay
Diagnostic investigations
1st investigations to order
- visual acuity tests (by specialist)
- stereopsis (perception of depth or 3-dimensionality) and binocular vision testing
- assessment of fixation, ocular alignment and ocular motility
- anterior segment exam using a slit lamp
- dilated fundoscopy
- cycloplegic retinoscopy
- binocular red reflex test (Brückner test)
Treatment algorithm
Contributors
Authors VIEW ALL
Professor of Ophthalmology
Department of Neuroscience, Psychology and Behaviour
University of Leicester
Ulverscroft Eye Unit
Leicester Royal Infirmary
UK
Disclosures
IG has undertaken amblyopia research supported by the National Eye Research Centre, the Ulverscroft Foundation, the National Institute of Health Research, and Action Medical Research. An employer of IG, The University of Leicester, holds a European patent for glass dose monitors. IG is an author of references cited in this topic.
Research Orthoptist
Department of Neuroscience, Psychology and Behaviour
University of Leicester
UK
Disclosures
GM declares that she has no competing interests. GM is an author of a reference cited in this topic.
Dr Irene Gottlob and Dr Gail Maconachie would like to gratefully acknowledge Dr Tina Rutar, the previous contributor to this monograph. TR declares that she has no competing interests.
Peer reviewers VIEW ALL
Associate Clinical Professor of Ophthalmology
Alpert Medical School of Brown University
Director of Ophthalmology
Hasbro Children's Hospital
Providence
RI
Disclosures
DRT declares that he has no competing interests.
Associate Professor of Ophthalmology and Pediatrics
Duke Eye Center
Durham
NC
Disclosures
DKW has received NEI grants of more than 6 figures USD. DKW is an author of a number of references cited in this topic.
Reader in Ophthalmology
Newcastle University
Newcastle
UK
Disclosures
MC has received NHS research grants of more than 6 figures USD. MC is an author of a number of references cited in this topic.
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