EyeHealth 101

🎯ISOMETRIC (AMETROPIC) AMBLYOPIA🎯
🔑Key Facts
• Visual impairment without apparent structural pathology (amblyopia) secondary to large bilateral refractive errors
• Typically asymptomatic and detected only with visual acuity testing or screening
• Age range of detection usually 3–7 years
• Association with strabismus is rare.

🔑Clinical Findings
• Visual acuity typically ranges from 20/40 to 20/80 (moderate):
• bilateral hyperopia of >5 D or
• bilateral astigmatism of >2.5 D in any meridian or
• bilateral myopia of >8 D
• otherwise normal ocular examination.

🔑Ancillary Testing
• Complete ophthalmic examination to rule out structural abnormality
• Full cycloplegic retinoscopy and manifest refraction
• Sensory motor testing.

🔑Differential Diagnosis
• Strabismic amblyopia
• Anisometropic amblyopia
• Deprivational amblyopia.

🔑Treatment
• Fully correct refractive error in both eyes with glasses as determined with cycloplegic retinoscopy
• In high hyperopia, as long as aniometropia is maintained and no strabismus is present the amount of correction can be reduced by 1–2 D to allow for
accommodation
• Consider contact lenses in older children.

🔑Prognosis
• Visual acuity improves slowly with treatment
• Visual acuity may not improve to better than 20/25 to 20/40
Post credits Elsevier for Medical Students