Detection, prevention, and rehabilitation of amblyopia

The necessity of visual preschool screening for reducing the prevalence of amblyopia is widely accepted. The beneficial results of large-scale screening programs conducted in Scandinavia are reported. Screening monocular visual acuity at 3.5 to 4 years of age appears to be an excellent basis for detecting and treating amblyopia and an acceptable compromise between the pitfalls encountered in screening younger children and the cost-to-benefit ratio. In this respect, several preschoolers' visual acuity charts have been evaluated. New recently developed small-target random stereotests and binocular suppression tests have also been developed with the aim of correcting the many false negatives (anisometropic amblyopia or bilateral high ametropia) induced by the usual stereotests. Longitudinal studies demonstrate that correction of high refractive errors decreases the risk of amblyopia and does not impede emmetropization. The validity of various photoscreening and videoscreening procedures for detecting refractive errors in infants prior to the onset of strabismus or amblyopia, as well as alternatives to conventional occlusion therapy, is discussed

Comment corriger un anisométrope?

Anisometropia may be responsible for aniseikonia. and anisophoria. In children, aniseikonia may create amblyopia. It is of utmost importance to distinguish axial from refractive anisometropia. When the anisometropia is axial in origin, spectacle lenses constitute the treatment of choice (Knapp's law). On the contrary, when the anisometropia is refractive in origin, contact lenses represent the first choice of treatment

Comitant strabismus.

This article briefly overviews the recent literature regarding comitant strabismus. The evaluation and management of esodeviations and exodeviations, which are still topical questions today, are discussed. Several relevant basic studies focus on the prevalence and the role of sensory mechanisms in the clinical findings of essential infantile esotropia. Data reported on by the authors reinforce the validity of early surgery in congenital strabismus. Other articles deal with the accommodative esotropia. The beneficial effect of adequate corrective eyeglasses in accommodative esotropia is emphasized, in both children and adult patients. A major informative review of intermittent exotropia and a worldwide survey of current management of intermittent exotropia are also presented

Neuroophthalmologic manifestations of systemic disease.

Significant contributions on the neuroophthalmologic manifestations of systemic disease have been published in the past year. The first part of this paper is devoted to practical guidelines that may help in the diagnosis and the management of oculomotor disorders, especially in connection with systemic diseases; the second part is focused on specific entities. Including idiopathic intracranial hypertension and ophthalmoplegic migraine in this review might be debatable; however, although the cause of these conditions is still unclear, relevant findings suggest that they may be the consequence of other adjacent processes rather than the cause itself. We believe that the diagnosis of idiopathic intracranial hypertension as well as that of ophthalmoplegic migraine remains a challenging issue for the ophthalmologist and may easily be overlooked