Treatment of Ametropic Amblyopia and the Significance of Cycloplegia in Childhood

Overview

Aims: This retrospective study evaluates the effect of full cycloplegic spectacle correction on best corrected visual acuity (BCVA), interocular difference in BCVA, and the presence of stereopsis in children previously treated for ametropic amblyopia (isoametropic or anisometropic type).

Material and Methods: We analyzed data from 43 children aged 4–12 years (mean 6.42 ±2.06 years) who had been previously diagnosed and treated for amblyopia. All underwent a complete ophthalmologic examination including cycloplegic refraction, BCVA, and stereopsis testing. The primary intervention was full correction of the refractive error based on cycloplegic refraction. The patients were monitored at 3-month intervals, and the effect of treatment was assessed after 12 months. The statistical analysis included a Shapiro-Wilk test, paired t-test or Wilcoxon test, and linear regression for evaluating the impact of age and prior occlusion therapy.

Results: Average BCVA improved significantly from 0.41 to 0.65 (p < 0.0001), with 65% of amblyopic eyes improving by ≥ 2 lines on the Snellen chart. Interocular difference was reduced by 41%, and stereopsis improved from 14% to 72%. The mean difference between non-cycloplegic and cycloplegic spherical equivalents prior to treatment was 2.26 D (p < 0.0001), supporting the diagnostic value of cycloplegia. The minimal change in cycloplegic refraction over the course of one year (p > 0.05) indicated refractive stability. A regression analysis detected an insignificant negative trend between age and BCVA improvement (p = 0.069).

Conclusion: Full spectacle correction based on cycloplegic refraction leads to a statistically significant improvement in BCVA and stereopsis. Routine use of cycloplegia is essential for precise diagnosis and optimal visual outcomes in pediatric amblyopia management.

Keywords:

children – cycloplegia – amblyopia – anisometropia – cycloplegic refraction