Distance versus near visual acuity in amblyopia
ABSTRACT There are conflicting reports about whether distance and near visual acuity are similar in eyes with amblyopia. The purpose of this study is to compare monocular distance visual acuity with near visual acuity in amblyopic eyes of children.
Subjects 2 to 6 years of age were evaluated in a randomized trial of amblyopia therapy for moderate amblyopia (20/40 to 20/80) due to anisometropia, strabismus, or both. Prior to initiating the protocol-prescribed therapy, subjects had best-corrected visual acuity measured with standardized protocols at 3 meters and 0.4 meters using single-surrounded HOTV optotypes.
A total of 129 subjects were included. The mean amblyopic eye visual acuity was similar at distance and near (mean, 0.45 logMAR at distance versus 0.45 logMAR at near; mean difference, +0.00, 95% CI, -0.03 to 0.03). Of the 129 subjects, 86 (67%) tested within 1 line at distance and near; 19 (15%) tested more than 1 logMAR line better at distance, and 24 (19%) tested more than 1 logMAR line better at near. The mean visual acuity difference between distance and near did not differ by cause of amblyopia, age, or spherical equivalent refractive error.
We found no systematic difference between distance and near visual acuity in 2- to 6-year-old children with moderate amblyopia associated with strabismus and/or anisometropia. Individual differences between distance and near visual acuity are likely due to test-retest variability.
Full-textDOI: · Available from: Michael X Repka, Jan 08, 2015
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ABSTRACT: To ascertain whether conventional treatment can improve visual function in adults with amblyopia. Sixteen patients aged 21-67 years old were instructed to wear glasses for refractive correction and to patch the non-amblyopic eye for at least 1 h per day. Visual acuity, measured with crowded optotypes for distance and near acuity, was checked every 3 months, and followed for a mean (SD) of 14.1 (4.2) months. Prognostic factors related to the subsequent results, an improvement of 3 or more lines logMAR in distance visual acuity, were evaluated. Of 16 patients, 5 (31 %) improved 3 or more lines of distance and 5 (31 %) in near acuity. The mean improvement in distance was 2.4 lines logMAR (95 % CI 1.4-3.5) and 2.4 lines logMAR for near acuity (95 % CI 1.5-3.3). Patients aged under 45 years (p = 0.0357) and with severe amblyopia (p = 0.0337), defined as a corrected distance visual acuity of worse than -0.699 logMAR, were associated with a good response. Conventional treatment may improve the visual acuity of amblyopic eyes even in adult patients.Japanese Journal of Ophthalmology 10/2013; DOI:10.1007/s10384-013-0279-z · 1.80 Impact Factor
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ABSTRACT: Purpose Assessment of visual acuity (VA) has been shown to vary between tests, which may be attributable in part to test inaccuracies, such as a change in the distance between the chart and subject. Therefore, the study aim was to quantify changes in chart/ patient separation during near and distance VA testing, and to analyse the relationship between VA and movement observed. Methods Volunteer orthoptists and subjects were filmed during near and distance VA testing, with the amount of movement determined from the recording. Controlling for movement using chin rests and chart stands, VA was retested. Actual changes in VA due to a change in subject or chart movement were compared with theoretical predictions. Results Fifty-one subjects (18–73 years) were assessed. Median (interquartile) movements of 0.06 m (0.07) towards and 0.11 m (0.08) away from the chart were measured (maximum 0.17 m towards and 0.24 m away). Significant differences in VA score were measured when movement was restricted, at near and distance (Po0.05). VA score change agreed with predicted values in 67% of the cases, however, reduced test distance during near vision testing resulted in a degradation of VA, opposite to the improvement expected. Conclusion There were significant variations in subject/chart separation during testing, which could have affected VA values. While this movement is associated with a change in VA, additional factors to movement appear to influence the score achieved during near testing. Procedures to minimise variation, by eliminating movement of test chart or subject, will improve VA test accuracy. Eye advance online publication, 24 October 2014; doi:10.1038/eye.2014.247Eye 10/2014; DOI:10.1038/eye.2014.247 · 1.90 Impact Factor