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IntroductionMethodsResultsConclusionAmblyopia is two Snellen line difference between both eyes. Red filter therapy is a treatment option for amblyopia based on principle of syntonic phototherapy. The purpose of this study is to assess the stereopsis in amblyopic patient using syntonic phototherapy.A Qusai experimental study was conducted from August 2021 to December 2021 at Madina Teaching Hospital Faisalabad. A total 30 subjects of both gender and ages ranging between 8 to 18 years were included through a non-probability purposive sampling technique. The sample was considered of 15 anisometropic amblyopes and 15 strabismic amblyope. Data was collected using a Performa and pre assessments of stereopsis by Titmus fly chart were recorded without red filter. Red filter glasses were prescribed for 4 week, post assessment data was recorded after 4 weeks. Data was analyzed by using Paired sample T test and Independent Sample T test in SPSS 20 software.After syntonic phototherapy significant improvement was seen, mean stereopsis was 48.00000 (p = 0.002) in anisometropic amblyopes while mean improvement of stereopsis 1.670.93333 (p = 0.00) in strabismic amblyopes. Anisometropic amblyopic patients showed significantly better improvement in stereopsis (p = 0.00) by syntonic phototherapy as compared to strabismic amblyopes.Significant improvement was seen in stereopsis, while improvement was more significant in anisometropic amblyopes as compared to strabismic amblyopes. Children were obsessed with the red filter glasses while their parents found syntonic therapy simple plus facile and gave good results. So, eye care professionals must be aware of this new therapy and they should keep syntonic phototherapy in mind whenever they are dealing with amblyopic patients. [ABSTRACT FROM AUTHOR]

Congenital inferior rectus hypoplasia and aplasia is a rare abnormality of the extraocular muscles, and it is the second most common after superior oblique muscle aplasia. It has been reported either in isolation or with coexisting ocular or systemic associations. We describe here cases of inferior rectus hypoplasia/aplasia, their clinical features, and surgical approach to achieve satisfactory outcomes. We retrospectively reviewed medical records from January 2009 to December 2020 of patients with vertical strabismus due to inferior rectus hypoplasia/aplasia at a tertiary eye care center. Those who underwent surgical intervention with an adequate follow up postoperatively were included in the study. Three patients who presented with congenital hypertropia and diagnosed of inferior rectus aplasia/hypoplasia and who underwent strabismus surgery were identified. Diagnosis was based on clinical examination and orbital imaging. Coexisting horizontal deviation was present in two patients. None of the patients had any other ocular, cranial, or systemic anomalies. All patients had isolated inferior aplasia/hypoplasia with normal other extraocular muscles on orbital imaging. Intraoperatively, ipsilateral superior rectus was tight in all patients. All underwent ipsilateral superior rectus recession, whereas two patients with large vertical strabismus required additional inferior oblique anteronasal transposition in the same eye. Satisfactory outcomes were achieved in all three patients without the need for resurgery. Moderate to large vertical A pattern strabismus and limitation of infraduction are common clinical findings. Orbital imaging helps not only in diagnosis but also in surgical planning. Weakening of antagonist superior rectus with anteronasal transposition of inferior oblique not only gives good surgical outcomes but also avoids potential complications related to vertical transposition of either horizontal rectus muscle. [ABSTRACT FROM AUTHOR]

Despite internationally recognized guidelines, amblyopia management varies among eye care professionals worldwide. Hence, we sought to investigate the practice patterns of amblyopia management and the factors associated with the decision to treat amblyopia among optometrists in Ghana. A cross-sectional survey was conducted among registered optometrists in Ghana from January 2020 to October 2020. Data collection was done through the administration of online questionnaires via e-mail (google form). The structured questionnaires included demographic information, mode, and scope of practice, diagnostic criteria, examination procedures, treatment modalities, and prognosis. A p value of less than 0.05 was deemed statistically significant. The mean (±SD) age of all the 168 respondents was 32.6 (±6.1) years (range: 24–50 years). The majority of the optometrists (64.9%) treated amblyopia in their practice; with the most prevalent being refractive amblyopia (68.2%), followed by strabismic amblyopia (27.1%), then form-deprivation amblyopia (4.7%). Most (76.1%) amblyopic patients presented with symptomatic squinting. The most common ocular and medical history was anisometropia (90.0%), and the most common diagnostic procedures were patient history, visual acuity, and refraction. Optical correction (88.3%) was mainly prescribed for amblyopia treatment, followed by patching (58.5%). Nearly half of the respondent (45.0%) reported good prognosis after amblyopia treatment. After statistical adjustment, female optometrists were significantly associated with decreased odds of treating amblyopia (AOR = 0.36, p =.004). Refractive amblyopia is the main type of amblyopia managed by optometrists in Ghana. Hence, optical correction is the primary treatment regime. Current amblyopia management practice among optometrists adhere to recommended guidelines and our findings demonstrate uniformity in the standard of care. [ABSTRACT FROM AUTHOR]

Cultural belief in Ethiopia showed that strabismus can be caused by exposure to sunlight during infancy, an outrage from God, and looking sideways. In addition, Ethiopians also believe that strabismus can resolve by its self and is a sign of good luck. Due to these reasons many patients with strabismus come to eye care clinics after developing amblyopia. This study aimed to assess the level of attitude and related factors toward strabismus among adults living in Gondar town, Northwest Ethiopia. A community-based cross-sectional study was conducted on a sample size of 634 adults from April 9 to April 23, 2019. Data were collected using a pretested structured questionnaire through face-to-face interviews, and the study participants were chosen by applying a multistage random sampling technique. Data were entered with EPI info version 7 and imported into SPSS version 20 for analysis. Frequency, statistical summary, and cross-tabulations were used for the descriptive analysis of the entered data. Binary logistic regression was fitted, and all independent variables with a P-value of less than 0.2 in the bivariable analysis were entered into a multivariable binary logistic regression. Variables with a P-value of less than or equal to 0.05 were considered statistically significant. Respondents who answered greater than or equal to the median score of attitude-related questions were designated to have a favorable attitude toward strabismus. In this study, 602 adults were participated with a response rate of 94.9% and the median age of the participants was 33 ± 14 years. The overall proportion of favorable attitudes toward strabismus was 71.8%. Having secondary school as an educational status (AOR = 2.8 (95% CI: 1.2, 6.4)) and heard about strabismus (AOR = 7.4 (95%CI: 3.7, 14.9)) were positively whereas being unemployed (AOR = 0.3(95% CI: 0.1, 0.7)) and high monthly income (AOR = 0.5(95%CI: 0.3, 0.9)) were negatively associated with a favorable attitude regarding strabismus. Eighty-five percent (88.5%) of participants agreed that early treatment of strabismus had a better outcome. Besides, 57.6% of participants have agreed that untreated strabismus can cause amblyopia. About three fourth of the study participants had a favorable attitude toward strabismus. Educational status, heard about strabismus, occupation, and monthly income were significantly associated with a favorable attitude toward strabismus. Most of the study participants agreed that untreated strabismus can cause poor cosmoses. Fear of surgery and high cost were reported by study participants as the main barriers to seeking treatment of strabismus. [ABSTRACT FROM AUTHOR]

Background/Aims: The Child Amblyopia Treatment Questionnaire (CAT-QoL) is a patient-reported outcome measure (PROM), designed to assess the impact of amblyopia treatment. The aim of this study was to compare the psychometric properties of two PROMs; the CAT-QoL instrument and Pediatric Quality of Life Inventory (PedsQLTM), a generic pediatric PROM. This work was part of a wider project to develop a condition-specific PROM for children with amblyopia. Methods: Three hundred and forty-two participants were recruited in a UK multi-center study. Quality of life data was collected using the CAT-QoL and the PedsQLTM instruments. The psychometric performance of the CAT-QoL and PedsQLTM were examined in terms of acceptability, reliability, and validity. Results: Both instruments demonstrated good reliability (CAT-QoL Cronbach's α = 0.793; PedsQLTMα = 0.872). The convergent validity of the CAT-QoL and PedsQLTM instruments was tested by comparing the instruments to each other. There was a moderate correlation between the PedsQLTM and the CAT-QoL scores, and this relationship was statistically significant (rs = −0.517, p <.000). No statistical significance was found between the level of amblyopia severity and the mean PedsQLTM score (p =.420). Conclusion: It was possible to assess the impact of amblyopia treatment using the CAT-QoL and PedsQLTM instruments. The preliminary findings from this are not conclusive, and it is not possible to advocate the use of one questionnaire over another based upon psychometric performance demonstrated here. This may be due to the sample population, as there were limited numbers of participants with severe amblyopia. Both the CAT-QoL and PedsQLTM instruments were noted to have some issues with ceiling effects at an individual item level. The CAT-QoL and PedsQLTM were reliable (as determined by Cronbach's alpha). The PedsQLTM instrument was not able to discriminate between amblyopia severity groups (discriminant validity). Further research is required to formally assess the psychometric properties of the CAT-QoL questionnaire. [ABSTRACT FROM AUTHOR]

Purpose: To determine the prevalence of strabismus and amblyopia, and the distribution of the near point of convergence (NPC), in a population of children aged 4 to 6 years. Methods: In this cross-sectional study, preschoolers in Mashhad were sampled using a random multistage cluster sampling approach. Examinations were done after obtaining parental consent. All participants had measurements of uncorrected visual acuity, corrected visual acuity, and non-cycloplegic refraction, and they had near and far cover tests to determine tropia and phoria. Results: Of the 3765 selected children, 3701 participated in the study. The prevalence of tropia was 1.21% (95% confidence interval [CI]: 0.86–1.57). Near and near/far tropia was observed in 0.83% (95% CI: 0.53–1.12) and 0.39% (95% CI: 0.18–0.59), respectively. Tropia was significantly more prevalent in boys (P=0.005). The most common type of tropia was esotropia, 0.22% (95% CI: 0.07–0.37). Among participants, 63.92% (95% CI: 62.36–65.48) had phoria; prevalence of far, near, and near/far phoria was 0.22% (95% CI: 0.07–0.37), 60.47% (95% CI: 58.88–62.07), and 3.22% (95% CI: 2.65–3.8), respectively. Mean NPC was 5.1 cm (95% CI: 5.05–5.14). NPC increased by 0.08 cm per month of age (P=0.033) and was 0.10 cm higher in boys compared to girls (P=0.027). Based on NPC, 61.58% (95% CI: 59.99–63.17) were symptomatic. The prevalence of amblyopia was 0.41% (95% CI: 0.20–0.61). The type of amblyopia was anisometropic, strabismic, and isoametropic in 75%, 11.1%, and 8.5%, respectively. Conclusion: The prevalence of amblyopia in this study population was not high; however, the prevalence of tropia was average compared to previous studies in Iran. Describing NPC in a 4- to 6-year-old Iranian population for the first time, we found that NPC increased with age in this sample. [ABSTRACT FROM AUTHOR]

Aims: The proportion of patients seen by the paediatric eye service that attend for reasons related to amblyopia has not been quantified. The purpose of this study was to quantify the proportion of patients seen in the paediatric eye service attending for reasons related to amblyopia. Methods: Records of all eye appointments of children attending the Hillingdon Hospitals NHS Foundation Trust and St Mary’s Hospital Imperial College Healthcare NHS Trust over one month in 2009 were examined to determine the diagnosis and reason for attendance. Results: Seven hundred and four patients had appointments booked at St Mary’s and Hillingdon in March 2009. The fail-to-attend rates were not significantly different at the 2 sites (19% at St Mary’s and 9% at Hillingdon;P=0.75). Of the 704 patients, 533 (St Mary’s, 252 [75%]; Hillingdon, 281 [76%]) were attending for amblyopia-related reasons. Of the overall 982 booked appointments, 770 (79%) were amblyopia-related. Conclusions: Amblyopia diagnosis and management is clearly the most common cause of attendance to the paediatric eye service, accounting for over three-quarters of outpatient visits. [ABSTRACT FROM AUTHOR]

Purpose: Bagolini striated glasses (BSG) can be used while performing the prism fusion amplitude to verify the maintenance of binocularity. The aim of this clinical study was to evaluate whether these glasses affect the prism fusion amplitude. Methods: Fifty-six subjects were examined at the Eye Care Clinic at the University of Applied Sciences Utrecht. The positive and negative prism fusion amplitudes were measured, incorporating the BSG at random, for both near and distance, with right and left eye fixating. Results: Fifty-two normal subjects with a mean age of 21 years (range 17-28) were recruited. The median prism fusion amplitude at near was 10 BI to 33 BO with the BSG and 13 BI to 38 BO without ( p < 0.001). At distance the median amplitude was 8 BI to 33 BO both with and without these glasses ( p = 0.104). Conclusion: Although BSG are useful to verify whether binocularity is maintained, significantly smaller fusional ranges were obtained during measurements at near. In clinical terms, fusional ranges can vary significantly when using the BSG. [ABSTRACT FROM AUTHOR]