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2016 ; 119
(1
): 75-86
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Childhood amblyopia: current management and new trends
#MMPMID27543498
Tailor V
; Bossi M
; Greenwood JA
; Dahlmann-Noor A
Br Med Bull
2016[Sep]; 119
(1
): 75-86
PMID27543498
show ga
INTRODUCTION OR BACKGROUND: With a prevalence of 2-5%, amblyopia is the most
common vision deficit in children in the UK and the second most common cause of
functional low vision in children in low-income countries. SOURCES OF DATA:
Pubmed, Cochrane library and clinical trial registries (clinicaltrials.gov,
ISRCTN, UKCRN portfolio database). AREAS OF AGREEMENT: Screening and treatment at
the age of 4-5 years are cost efficient and clinically effective. Optical
treatment (glasses) alone can improve visual acuity, with residual amblyopia
treated by part-time occlusion or pharmacological blurring of the better-seeing
eye. Treatment after the end of the conventional 'critical period' can improve
vision, but in strabismic amblyopia carries a low risk of double vision. AREAS OF
CONTROVERSY: It is not clear whether earlier vision screening would be cost
efficient and associated with better outcomes. Optimization of treatment by
individualized patching regimes or early start of occlusion, and novel binocular
treatment approaches may enhance adherence to treatment, provide better outcomes
and shorten treatment duration. GROWING POINTS: Binocular treatments for
amblyopia. AREAS TIMELY FOR DEVELOPING RESEARCH: Impact of amblyopia on education
and quality of life; optimal screening timing and tests; optimal administration
of conventional treatments; development of child-friendly, effective and safe
binocular treatments.