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Background: Previous reports have suggested that one-fourth of amblyopic subjects present with recurrence of amblyopia even after successful primary treatment. Risk factors for amblyopia recurrence are insufficiently studied, but therapy weaning has recently been suggested as a method for reducing the risk of recurrence., Methods: In the second phase of a prospective study examining the results of treatment for amblyopia, all 35 children with successful primary amblyopia treatment were put on maintenance therapy. Maintenance therapy consisted of low-intensity patching, atropine, or blurring filter, and all children were regularly examined up to at least 8 years of age. Mean age at start of maintenance therapy was 4.3 years (range, 2-7 years)., Results: Of the 35 cases with successful primary treatment, 6 cases deteriorated >or=0.2 logMAR, which was considered recurrence of amblyopia. Two of these cases had a second recurrence. Notably, all six subjects presenting with recurrence had microstrabismus. This finding was just outside statistical significance at the 95% confidence level (p = 0.06), but the sample size was small. All but one of the recurrences appeared within 6 months after successful primary treatment. Age at successful primary treatment or initial interocular difference of visual acuity did not affect the risk of recurrence., Conclusions: Recurrence of amblyopia occurred in 17% of patients despite maintenance therapy and was associated with microstrabismus. The majority of recurrences occurred within the first 6 months after primary treatment.

Purpose: To evaluate the effectiveness of the Lang II stereo card as a screening test for amblyopia and/or strabismus., Methods: A total of 1046 children aged 12-13 years were examined in a field study in the Göteborg area, Sweden. In addition to the Lang II stereo card, the examination included visual acuity, cover testing, cycloplegic refraction, and inspection of the optical media and posterior pole., Results: If every incorrect subject response was considered a reason for referral, the Lang II test would have correctly identified 82% (23 subjects) of the 28 children with manifest strabismus and 38% (11 subjects) of the 29 children with amblyopia. The test failed to refer 45% (21 subjects). Of all subjects referred, 44 (63%) were found to be ophthalmologically normal., Conclusions: The Lang II stereo card is neither a reliable nor an efficient method of screening for amblyopia and/or strabismus.

Purpose: To study the long-term visual outcome and the age at which final visual acuity can be predicted in a population sample of children treated surgically for bilateral dense congenital cataract before 37 weeks of age. In addition, we assessed the influence of associated risk factors and compared the visual development of these aphakic children with presumably blocked visual input before early surgery to that of normal children in Sweden. Methods: The 18 patients included were followed for at least 10 years postoperatively. The median age at last visit was 15.5 years (range 10-18). The bestcorrected visual acuity (BCVA) was tested monocularly with a logarithmically scaled letter acuity test from 4 years of age to late teens. Other registered postoperative data were presence of manifest nystagmus, strabismus and complications. Results: The BCVA of the better-seeing eye reached a plateau at 7 years of age. Age at surgery of 80 days or less characterized the majority of cases with a logMAR ⩽ 0.3 with a threshold effect between 80 and 130 days of age. Compared to normal children in Sweden, the long-term visual outcome showed a deficit of 0.5-0.6 logMAR. Conclusion: In spite of optimized care and surgery before 9 months, the BCVA was subnormal in our population compared to healthy children. The long-term visual outcome can be predicted at 7 years of age. Screening with early detection followed by surgery before the end of the third month is important to decrease the risk of marked acuity loss. [ABSTRACT FROM AUTHOR]