By the American Academy of Ophthalmology Preferred Practice Pattern Pediatric Ophthalmology/Strabismus Panel: David K. Wallace, MD, MPH,1 Michael X. Repka, MD, MBA,2 Katherine A. Lee, MD, PhD,3 Michele Melia, ScM,4 Stephen P. Christiansen, MD,5 Christie L. Morse, MD,6 Derek T. Sprunger, MD7
As of November 2015, the PPPs are initially published online-only in the Ophthalmology journal and may be freely downloaded in their entirety by all visitors. Open the PDF for this entire PPP or click here to access the journal's PPP Collection page.
1 Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, Indiana
2 Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
3 Pediatric Ophthalmology, St. Luke’s Health System, Boise, Idaho
4 Jaeb Center for Health Research, Tampa, Florida
5 Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
6 Concord Eye Center, Concord, New Hampshire
7 Indiana University Health Physicians, Midwest Eye Institute, Indianapolis, Indiana
HIGHLIGHTED FINDINGS AND RECOMMENDATIONS FOR CARE
Treatment of refractive error alone can improve visual acuity in children who have untreated anisometropic and strabismic amblyopia. Visual acuity of children who have bilateral refractive amblyopia also can substantially improve with refractive correction alone.
Most children who have moderate amblyopia (20/40 to 20/80) respond to initial treatment consisting of 2 hours of daily patching or weekend atropine.
Following treatment of amblyopia caused by strabismus, anisometropia or both combined, continued monitoring and treatment, if needed, is associated with long-term stability of the visual acuity improvement.
Suitable treatment options for amblyopia may include optical correction, patching, pharmacological treatment, optical treatment, Bangerter (translucent) filters, and/or surgery to treat the cause of amblyopia.
Patching may be effective in older children and teenagers, particularly if they have not previously been treated.