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Anisometropic Amblyopia: Nonsurgical Treatment

Correspondence: Requests for reprints should be addressed to: Claire Castleberry Hennessey, C.O., Children's Eye Center of South Texas, 85 NE Loop 410, Suite 112, San Antonio, TX 78216.

Introduction: Anisometropia is the leading cause of amblyopia, and research suggests that it too often goes undiagnosed and untreated. To assist with early detection of amblyogenic risk factors (media opacities, strabismus, and/or refractive error), the vision screening committee of the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) has developed vision screening guidelines. Any child that meets these failure/referral criteria should be referred for further ophthalmological evaluation to prevent the onset of amblyopia.

Timing of Treatment: The exact time at which to prescribe glasses correcting significant anisometropia is somewhat unclear. However, the child's age and the type and degree of anisometropia that is present can be useful in predicting possible insults to the developing visual system.

Treatment Method: Various amblyopia treatment modalities and how successful they are in complete vision restoration have been explored recently. Refractive adaptation, six hours of daily patching, weekend-only use of atropine and combining atropine with optical penalization have all been proven effective at treating moderate amounts of anisometropic amblyopia. The risk factors for each method, the type and degree of anisometropia, and the patient's age and level of visual acuity should all be considered when choosing the best treatment plan for the patient.

Key words: anisometropic amblyopia, nonsurgical treatment, refractive adaptation, patching, atropine penalization