Long-Term Functional Effect of the Photo Screening in Ocular Diseases Causing Amblyopia

Authors: M. Dostálek 1;  J. Běláček 2;  A. Zárubová 2;  J. Dušek 2
Authors‘ workplace: Centrum pro funkční poruchy vidění, Litomyšlská nemocnice, a. s., Litomyšl, vedoucí lékař MUDr. Miroslav Dostálek, Ph. D. 1;  Ústav biofyziky a informatiky, 1. lékařská fakulta UK, Praha, přednosta prof. MUDr. RNDr. Jiří Beneš, CSc. 2
Published in: Čes. a slov. Oftal., 66, 2010, No. 1, p. 3-7


Amblyopia represents the most common cause of insufficient monocular visual acuity in productive age. To begin the treatment in the early childhood is understood as the fundamental anticipation to achieve the optimal result. The research work concerns about the development of screening methods. Our retrospective study was not focused toward the efficacy of the screening itself, but it had to establish, how the participation of the suckling babies in the screening program influences the chance of good vision. The data analyzed in this study were obtained from retrospective review of medical records of two groups of patients of the Center for functional visual disorders. Four hundred and nineteen (419) patients with positive finding in the photo screening, selected by chance, were included into the study (SC group). In the second group, there were included 263 randomly selected patients who did not pass the photo screening procedure and to the first examination were referred by the pediatrician (PLDD group). The average age at the time of the first examination was 13 months in children from the SC group and 23 months in children from the PLDD group respectively. The difference was statistically highly significant. In both groups, the severity of the amblyopia related to the comparable degree of anisometropia and the degree of the involvement of binocular functions in strabismus related to the comparable degree of hypemetropia were compared. The data were evaluated according to the age of the child patients at the time of the examination used for the purpose of this study as well. The obtained data show, that the decrease of the visual acuity of the amblyopic eye in case of equal anisometropia is significantly higher in two to three years old children who were not screened. In older children, the results in the in the SC and PLDD groups did not significantly differ. The results of our study indicate that later (before the age of three years) beginning of systematic pleoptic treatment related to the absence in the screening program is not worsening the chance to good visual acuity at the age of six years in case of moderate to mid-severe amblyopia. The first examination indicated by the pediatrician later, at the time of evident signs of strabismus, may decrease the chance to the good functional results of the complex strabological treatment at the age of six years.

Key words:
photo screening, amblyopia, strabismus, efficacy


1. Report on the National Eye Institute’s Visual Acuity Impairment Survey Pilot Study, Office of Biometry and Epidemiology, National Eye Institute, National Institutes of Health, Public Health Service, Washington, 1984.

2. Atkinson, J., Braddick, O., Ayling, L. et al.: Isotropic photorefraction: a new method for photorefractive testing in infants. Doc. Ophthalmol., 30, 1982; Proceedings Series: 217–223.

3. Atkinson, J., Braddick, O., Bobier, O. et al.: Two infant vision screening programmes: prediction and prevention of strabismus and amblyopia from photo- and videorefractive screening, Eye, 10, 1996; 2: 189-198.

4. Bailey, I.L.: Visual acuity, 179 - 202. In Benjamin, W. J. (Ed.): Borisch’s Clinical Refraction. W. B. Saunders Company, Philadelphia, London, Toronto, Montreal, Sydney, Tokyo, 1998, 1255 s.

5. Bobier, W.R., Braddick, O.J.: Eccentric photorefraction optical analysis and empirical measures. Am. J. Optom. Physiol. Opt., 62, 1985; 9: 614–620.

6. Commttee on Practice and Ambulatory Medicine and Section on Ophthalmology American Academy of Pediatrics: Use of photoscreening for childrenęs vision screening. Pediatrics, 109, 2002; 3: 524–525.

7. Donahue, S.P., Johnson, T.M.: Age-based refinemnt of referral criteria for photoscreeing. Ophthalmology, 108, 2001; 12: 2314–2315.

8. Dostalek, M.: Současné trendy ve fotoscreeningu amblyogenních očních vad a strabismu. Folia strabologica et neuroophthalmologica, 9, 2006; Supplementum 1: 23–29.

9. Fawcett, S.L., Birch, E.E.: Risk factors for abnormal binocular vision after succesful alignment of accommodative esotropia. J. AAPOS., 7, 2003; 4: 256–262.

10. Flynn, J., Woodruff, G., Thompson, J. et al.: The therapy of amblyopia: an analysis comparing the results of amblyopia therapy utilizing two pooled data sets. Trans. Am. Ophthalmol. Soc., 97, 1999; 373 –390.

11. Howland, H.C.: Optic of photoretinoscopy: Results from ray tracing. Am. J. Optom. Physiol. Opt., 62, 1985; 9: 621-625.

12. Howland, H.C., Howland, B.: Photorefraction: a technique for stduy of refractive state at a distance. J. Opt. Soc. Am., 64, 1974; 2: 240–249.

13. Kasal, P., Svačina, Š. et al.: Lékařská informatika. Karolinum, Praha, 1998, 543 s.

14. Simons, K.: Amblyopia characterization, teratment, and prophylaxis. Survey of Ophthalmology, 50, 2005; 2: 123-166.

15. Snell, A.C., Sterling, S.: The percentage evaluation of macular vision. Arch. Ophthalmol., 54, 1925; 443-461.

16. Snowdon, S.K., Steward-Brown, S.L.: Preschool vision screening. Health Technology Assessnemt Review, 1, 1997; 1–86.

17. Trogrlic, K.: Der zentrale Schatten in der Pupille oder die binokulare Photoskiaskopie. Klin. Monatsbl. Augenheilkd., 144, 1964; 5: 696–703.

18. van de Graaf, E.S., van der Sterre, G.V., Polling, J.R. et al.: Amblopia & strabismus questionnaire: design and initial validation. Strabismus, 12, 2004; 3: 181–193.

19. Wasserman, R.C., Croft, C.A., Brotherton, S.E.: Preschool vision screening in pediatric practice: a study from the Pediatric Research in Office Settings (PROS) Network. Pediatrics, 89, 1992; 5: 834-838.

20. Williams, C., Northstone, K., Harrad, R.A. et al.: Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial. BMJ, 324, 2002; 7353: 1549.

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