Astigmatism-related amblyopia can be successfully treated in preschool children

The authors of this study evaluated children who were enrolled in a larger study of optical treatment of astigmatism-related amblyopia when they were 3 to 5 years old. All 73 children had ≥1.50 D of with-the-rule astigmatism (plus cylinder axis ≥ 70° and ≤ 110°) in the right eye, but no significant anisometropia (≥1.50 D difference in spherical equivalent between eyes) and no other ocular abnormalities other than amblyopia.

Thirty-nine children received optical correction for astigmatism, while 34 received no treatment. By the time the treated children reached 5 to 7 years old, the treated group the average best corrected visual acuity in the treated group was 20/40 or better, compared to 20/50 in the untreated group.

Although the present study suggests that optical treatment during preschool years results in a reduction in amblyopia by the time children reach kindergarten, future studies are needed to examine the effects of optical correction before the preschool years, preferably before the development of amblyopia, to determine if there is an additional benefit of even earlier optical correction. It would also be of interest to determine whether the difference in average letter recognition acuity between children in the treated and untreated groups is eliminated by the time they reach first grade, after the untreated Group has had approximately a year of spectacle wear.