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Clinical Education / Education / Disease Reviews
OCT 21, 2015
Types of Amblyopia
By Rebecca Sands Braverman, MD
Amblyopia
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Refractive Amblyopia
Uncorrected refractive errors are considered the
most common cause of amblyopia. There are two
main types of refractive amblyopia. Anisometropic
amblyopia refers to unilateral amblyopia caused by
a distinct refractive error of each eye. Isoametropic
amblyopia occurs when both eyes are amblyopic
from a significant yet similar refractive error.
Severity of the refractive error and the amblyopia
are directly related. Anisometropic amblyopia is
likely in the presence of 1.0–1.5 D or more
anisohyperopia, 2.0 D or more anisoastigmatism,
and 3.0–4.0 D or more anisomyopia. Bilateral or
isoametropic amblyopia may occur in the presence
of 5.0–6.0 D or more of myopia, 4.0–5.0 D or more
of hyperopia or 2.0–3.0 D or more of astigmatism.
Amblyopia caused by significant astigmatism is
referred to as meridional amblyopia.1-2
The Academy has published treatment guidelines
for refractive correction in infants and young
children (Table 1). Treatment of refractive
amblyopia may require only spectacle correction.
Strabismic Amblyopia
Strabismic amblyopia results from suppression of
the deviating eye. Constant strabismus leads to
more severe amblyopia than intermittent
strabismus. The optimal timing of strabismus
surgery in individuals with strabismic amblyopia
remains unknown.3
Deprivation Amblyopia
Deprivation amblyopia is the least common and
typically most severe form of amblyopia and
develops when the visual axis is obstructed.
Various causes of stimulus deprivation include
eyelid ptosis, cornea opacities, cataracts, vitreous
hemorrhage among others.
Reverse Amblyopia
Reverse amblyopia is a result of penalizaton of the
sound eye with patching or atropine during
amblyopia treatment of the original amblyopic eye.
The type of amblyopia and its severity not only
adversely affect visual acuity but also binocularity,
contrast sensitivity, grating acuity, and central
versus eccentric fixation.
Related Resource
AAO Preferred Practice Patterns Amblyopia 2012
References
1. BCSC Pediatric Ophthalmology and
Strabismus. Section 6. 2014-15.
2. In DynaMed [database online]. EBSCO
Information Services.
http://www.dynamed.com/login.aspx?
direct=true&site=DynaMed&id=113862.
Updated April 25, 2015. Accessed May 17,
2015.
3. Korah S, Philip S, Jasper S, Antonio-Santos
A, Braganza A. Strabismus surgery before
versus after completion of amblyopia therapy
in children. Cochrane Database Syst Rev.
2014 Oct 15;10:CD009272.
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