Treatment of astigmatism-related amblyopia in 3- to 5-year-old children

AbstractBest-corrected acuity was measured for vertical and horizontal gratings and for Lea Symbols® recognition acuity in 3- to 5-year-old children with high astigmatism and in non-astigmatic children. There was significant amblyopia among astigmatic children at baseline. There was no evidence that eyeglass correction of astigmatism resulted in a reduction in amblyopia over a 4-month average treatment duration (although vision in astigmatic children was significantly improved immediately upon eyeglass correction, indicating that eyeglass correction did provide a visual benefit). Treatment outcome results are discussed in terms of both methodological issues and theoretical implications

Visual Acuity Screening of Children 6 Months to 3 Years of Age

The operant preferential looking (OPL) procedure allows a behavioral estimate of visual acuity to be obtained from children 6 mo to 3 yr of age. In clinical settings, there is often too little time available to obtain an acuity estimate with the standard OPL procedure. The goal of this study was to identify specific spatial frequencies, termed diagnostic grating frequencies, that could enable the OPL technique to be used as a screening procedure under conditions where completion of acuity estimation was not possible. One hundred eighty presumptively normal children, 6, 12, 18, 24, 30, and 36 mo of age, were each tested with up to 20 trials of a potential diagnostic grating frequency to determine the highest spatial frequency grating that could be resolved by 90% of children at each age. For all ages except 18 mo, there existed a spatial frequency that produced uniformly high OPL performance within the age group; this spatial frequency was separated by one-half to one octave from a higher spatial frequency that more than 30% of children at that age failed to detect. These results suggest that at all ages except 18 mo, it should be possible to use the OPL procedure as a vision screening tool by testing individual children with the diagnostic grating frequency appropriate for their age. Invest Ophthalmol Vis Sci 26:1057-1063, 1985 The course of visual acuity development in normal infants less than 6 mo of age has been well described with preferential looking (PL) and forced-choice preferential looking (FPL) procedures (reviewed by Dobson and Teller 1 ). With the addition of operant reinforcement to the preferential looking procedure, data on the acuity development of normal children in the 6-mo to 3-yr age range have also become available. 2 " 4 Thus, normative preferential looking acuity data are available over a wide age range and can be used for comparison with preferential looking acuity data from infants and young children who have suspected vision problems. Unfortunately, however, the binomial variability inherent in these discrete-trial procedures produces acuity estimates that are severely limited in accuracy unless the child is tested with a large number of trials

Associations between anisometropia, amblyopia, and reduced stereoacuity in a school-aged population with a high prevalence of astigmatism. Invest Ophthalmol Vis Sci.

PURPOSE. To describe the relation between magnitude of anisometropia and interocular acuity difference (IAD), stereoacuity (SA), and the presence of amblyopia in school-aged members of a Native American tribe with a high prevalence of astigmatism. METHODS. Refractive error (cycloplegic autorefraction confirmed by retinoscopy), best corrected monocular visual acuity (VA; Early Treatment Diabetic Retinopathy Study logMAR charts), and best corrected SA (Randot Preschool Stereoacuity Test) were measured in 4-to 13-year-old Tohono O'odham children (N ϭ 972). Anisometropia was calculated in clinical notation (spherical equivalent and cylinder) and in two forms of vector notation that take into account interocular differences in both axis and cylinder magnitude. RESULTS. Astigmatism Ն 1.00 D was present in one or both eyes of 415 children (42.7%). Significant increases in IAD and presence of amblyopia (IAD Ն 2 logMAR lines) occurred, with Ն1 D of hyperopic anisometropia and Ն2 to 3 D of cylinder anisometropia. Significant decreases in SA occurred with Ն0.5 D of hyperopic, myopic, or cylinder anisometropia. Results for vector notation depended on the analysis used, but also showed disruption of SA at lower values of anisometropia than were associated with increases in IAD and presence of amblyopia. CONCLUSIONS. Best corrected IAD and presence of amblyopia are related to amount and type of refractive error difference (hyperopic, myopic, or cylindrical) between eyes. Disruption of best corrected random dot SA occurs with smaller interocular differences than those producing an increase in IAD, suggesting that the development of SA is particularly dependent on similarity of the refractive error between eyes. (Invest Ophthalmol Vis Sci. 2008;49:4427-4436

Adult Discrimination Performance for Pediatric Acuity Test Optotypes

Pediatric acuity tests have a variety of optotype designs. Adult performance when discriminating these targets indicated that acuity estimates collected from children are likely to vary based solely on target design

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Exhibitors will be in the Bonboo Foyer outside the Bonsai and Boojam rooms. Dear Participants, Welcome to the fifth annual OSA Fall Vision Meeting (FVM). The FVM sprang from the OSA Annual Meeting four years ago to allow greater scheduling flexibility at reduced cost. The first meeting was hosted by the University of California, Irvine, followed by meetings hosted by Smith-Kettlewell (Sa