• Written By: Denise Hug, MD
    Pediatric Ophth/Strabismus

    This is an important article because it attempts to determine the functional impact of amblyopia. The authors explored the effects of amblyopia on fine motor skills in school age children by performing standardized tests of visual motor control (VMC) and upper limb speed and dexterity (ULSD) from the Bruininks-Oseretsky Test of Motor Proficiency on amblyopes and age-matched controls.

    As a whole, the amblyopes performed worse on VMC tests than controls, but this difference did not reach statistical significance. However, on ULSD tests, the control group's outperformance of the amblyopic group was statistically significant. Significant differences were also measured between the groups on three of the VMC items and six of the ULSD items.

    The study group was composed of 82 subjects diagnosed with amblyopia or amblyogenic conditions who had a mean age of 8.2 and were patients of a single pediatric ophthalmology practice. The selection of amblyopic patients appeared to be nonrandom; a high percentage of them had hyperopia, whereas the control group of 37 children did not have this bias. The patients had amblyopic conditions of varying etiologies that had been treated, although some had residual deficits in acuity.

    The subjects performed eight visual motor control tasks, such as drawing a line through a crooked path, which was graded based on the number of errors, and copying a geometric shape, graded based on accuracy. The eight ULSD tasks included making dots in circles and sorting two types of cards by color, both of which subjects were instructed to perform correctly as many times as possible in 15 seconds.

    Multivariate analysis was performed to try to determine if a specific factor, such as visual acuity in the better eye, interocular visual acuity difference, stereopsis, or etiology of amblyopia had an impact on fine motor skills. The only statistically significant association of fine motor skill performance was a history of strabismus.

    The results of this article support several previously published articles on the subject. The fact that strabismic subjects performed poorly when compared with others and the deprivation group's performance equaled that of the control group suggests that factors other than just stereopsis and visual acuity have an impact on fine motor skills.

    Although it is interesting to see the effects of amblyopia on fine motor skill test performance, the condition's impact on academic development remains unknown. Results comparing untreated amblyopes and treated amblyopes might also be intriguing.