Authors
RUTSTEIN, ROBERT P. OD, MS, FAAO; CORLISS, DAVID A. OD, PhD

Long-Term Changes in Visual Acuity and Refractive Error in Amblyopes

publication date
February 19, 2004
Category
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Abstract/Introduction

Purpose

To report long-term changes in visual acuity and refractive error for strabismic, anisometropic, and isoametropic amblyopes.

 

Methods

Records of patients with strabismic amblyopia, anisometropic amblyopia, and isoametropic amblyopia who were treated from 1983 to 1993 were reviewed. Excluded were patients having ocular or neurological diseases, developmental delay, and follow-up <4 years after treatment cessation. Data included best-correctable visual acuity and spherical equivalent refractive error of the amblyopic and the nonamblyopic eye at pretreatment, posttreatment, and long-term follow-up.


Conclusion/Results

Results

Records for 61 patients met the inclusion criteria. For strabismic amblyopia (n = 22), mean visual acuity in amblyopic and nonamblyopic eyes improved 0.36 and 0.05 logarithm of the minimum angle of resolution (logMAR) units after a mean treatment time of 1 year. At long-term follow-up (mean = 9.3 years after treatment), visual acuity in the amblyopic eye regressed 0.09 logMAR and visual acuity in the nonamblyopic eye improved 0.10 logMAR units. For anisometropic amblyopia (n = 26), mean visual acuity in amblyopic and nonamblyopic eyes improved 0.30 and 0.02 logMAR units, respectively, after a mean treatment period of 1.1 year. At the long-term follow-up visit (mean = 7.1 years after treatment), visual acuity in the amblyopic eye regressed 0.09 logMAR unit and in the nonamblyopic eye improved 0.03 logMAR unit. Repeated-measures analysis of variance showed no significant effect of type of amblyopia on visual acuity of the amblyopic eye and a significant effect of visit due to treatment but not regression. The changes in visual acuity in the nonamblyopic eye from the pretreatment to the follow-up visit were significant and interacted with type, the changes being larger in strabismic amblyopia. For strabismic amblyopia, the mean refractive error in amblyopic and nonamblyopic eyes changed from +2.15 D and +1.85 D, respectively, initially to +0.45 D and +0.58 D, respectively, at the follow-up visit. For anisometropic amblyopia, the mean refractive error in amblyopic and nonamblyopic eyes changed from +1.04 D and +0.12 D, respectively, initially to +0.23 D and −0.94 D, respectively, at the follow-up visit. The effect of visit on amblyopic and nonamblyopic refractive errors was significant. For isoametropic amblyopia (n = 13), visual acuity in both right and left eyes initially was 0.39 logMAR unit and improved to 0.14 logMAR unit in each eye after a mean follow-up of 8.9 years. Refractive error in the right and the left eyes changed from −1.22 D and −1.14 D, respectively, to −2.68 D and −2.56 D, respectively, at follow-up. These differences were all significant.

 

Conclusions

After treatment and with long-term follow up, visual acuity regresses but not significantly in the amblyopic eye in strabismic amblyopia and anisometropic amblyopia. At the same time, visual acuity in the nonamblyopic eye improves slightly. Visual acuity also improves significantly over time in isoametropic amblyopia. The refractive error of both amblyopic and nonamblyopic eyes tends to show a myopic shift regardless of the type of amblyopia.


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Testimonials


My eight year old daughter was terrified to go to the eye doctor for fear of her eyes being dilated. The doctor was SO KID friendly! He immediately made her comfortable by engaging her in conversation. It was a geat experience.


Joya B.

Dr. Garbus spent an amazing amount of time to solve my very complicated visual problems. Over the years he has continually achieved results beyond what others felt possible. He is always up to date on the latest science. He is great!


Dolores K.

Family Vision Care Valencia makes it so easy. Staff is knows what they are doing and Dr. Garbus is thorough and kept me well informed during the exam.


Kristy B.

I have been coming to Family Vision Center for almost 20 years. Dr. Garbus has been able to help my vision when other doctors could not. Now my kids see him as well. I highly recommend this office!


Autumn C.

The Doctor is very good. I felt on this visit he seemed rushed. I had questions to ask him but he was already with another patient. I still do not know if my eyes are the same , worse, or better.


Howard B.

All the staff is friendly, helpful and knowledgeable, and has been for all the years I have been going there.


Mary Ann H.
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