Clinical practice guide for prevention, early detection diagnosis, treatment and follow-up of Amblyopia in children under 18 years
Article Sidebar
Published:
Jun 24, 2017
Keywords:
Guía de Práctica Clínica, Ambliopía, tamizaje, diagnóstico, tratamiento.
Main Article Content
Abstract
Objective:
To generate recommendations for the prevention, early detection, diagnosis, treatment, and follow-up of amblyopia in children under 18, in order to support health care professionals taking care of them in the different attention services.
Material and methods: An interdisciplinary Guide Development Group (GDG) was gathered. The scope, objectives, questions and outcomes of the guide were delineated. A search for guidelines on the management of amblyopia was carried out. The guidelines found were rated with the AGREE II Instrument. The American Association of Ophthalmology (AAO) Clinical Practice Guideline (GPC) for Amblyopia of 2012 (1) fulfilled the requirements to adopt the set of evidence found in it and adapt its recommendations. In order to update the information of the mentioned guide, we searched systematic reviews, clinical trials, cohort studies, case-control studies in the MEDLINE, EMBASE and CENTRAL databases, published one year prior to the date of the search conducted by the AAO Guide. The methodological quality of the selected articles was evaluated. The tables of evidence were elaborated using GRADEpro® 3.6 software and recommendations were generated using the GRADE methodology.
Results: the guide offers recommendations for the prevention, early detection, diagnosis, treatment, and follow-up of amblyopia in children under 18. Additionally, several general questions are presented in order to provide a context on the subject of the GPC, without intending to propose recommendations.
Downloads
Download data is not yet available.
Article Details
How to Cite
Sanchez Vanegas, G., Buitrago García, D. C., Buitrago García, D. C., Moreno, C., Segura, M. M., Fernández Jaramillo, J., … Angulo, S. (2017). Clinical practice guide for prevention, early detection diagnosis, treatment and follow-up of Amblyopia in children under 18 years. Pediatría, 50(1). https://doi.org/10.14295/pediatr.v50i1.78
Section
Originals
Creative Commons
License Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0)
You are free to:
Share - copy and redistribute the material in any medium or format.
Adapt - remix, transform, and build upon the material The licensor cannot revoke these freedoms as long as you follow the license terms.
• Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
• NonCommercial — You may not use the material for commercial purposes.
• ShareAlike — If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.
• No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
References
1. AAO Pediatric Ophthalmology/Strabismus Panel. PPP Guidelines. Amblyopia. San Francisco CA. AAO. 2012
2. DeSantis D. Amblyopia. Pediatric clinics of North America 2014;61(3):505-18
3. Thompson JR, Woodruff G, Hiscox FA, Strong N, Minshull C. The incidence and prevalence of amblyopia detected in childhood. Public Health 1991;105(6):455-62
4. Figueroa LF. Astigmatism, a risk factor for amblyopia. 2004
5. Carrasquilla G, Pulido A, De la Hoz A, Mieth k, Muñoz O, Guerrero R, et al. Guía Metodológica para la elaboración de Guías de Práctica Clínica con Evaluación Económica en el Sistema General de Seguridad Social en Salud Colombiano-Versión completa final. Fundación Santa Fe de Bogotá – Centro de Estudios e Investigación en Salud 2014:1-312
6. AGREE, Next, Steps, Consortium. The AGREE II Instrument [Electronic version]. Consultado en marzo de 2014, de http://www.agreetrust.org. 2009
7. Marroquín G. Oftalmología Pediátrica: Guías de Manejo. Asociación Colompiana de Oftalmología Pediátrica y Estrabismo ACOPE. 2006
8. Sjostrand J, Abrahamsson M. Risk factors in amblyopia. Eye (Lond) 1990:(Pt 6):787-93
9. Puertas D, Gimeno A, Ruiz-Falcó M, Torrelo A, Ardila M, Celada M, et al. Hemangiomas gigantes hemifaciales y síndrome phace: alteraciones oculares asociadas. Acta Estrabológica 2000;(XXIX):15-20
10. Pascual M, Huang J, Maguire M, Kulp M, Quinn G, Ciner E, et al. Risk factors for amblyopia in the vision in preschoolers study. Ophthalmology 2014;.121(3):622-9.e1
11. Simons K. Amblyopia characterization, treatment, and prophylaxis. Surv Ophthalmol 2005;50(2):123-66
12. López J, Osandón D, Denk O, Stevenon R, Agurto R, Uauy A, et al. Prevalencia de patología oftalmológica en prematuros menores de un año de edad. Rev chil pediatr 2012;83(6):570-6
13. Ellis G, Frey T, Gouterman R. Myelinated nerve fibers, axial myopia, and refractory amblyopia: an organic disease. J Pediatr Ophthalmol Strabismus 1987;24(3):111-9
14. Moguel-Ancheita S, Orozco-Gómez L. Disfuncionalidad neuronal y psicomotora como resultado del retraso en el tratamiento de la ambliopía. Cir Cir 2007;75:481-9
15. Yang Q, Wen S, Smith G, Chen Y, Krewski D, Chen X, et al. Maternal cigarette smoking and the risk of pregnancy-induced hypertension and eclampsia. Int J Epidemiol 2006;35(2):288-93
16. Lan W, Zhao F, Li Z, Zeng J, Liu W, Lu J, et al. Validation and cost-effectiveness of a home-based screening system for amblyopia. Ophthalmology 2012;119(6):1265-71
17. Morales P, Alramadam M, Serrano B, Martínez F. Ambliopía Tabaco Alcohol. Rev Clín Med Fam 2010;3(1):57-60
18. Parra J, García R, Farran M, Cutillas M, March E, Herrero E, et al. Optometría. Manual de exámenes clínicos. Universitat Politecnica de Catalunya Iniciativa Digital Politecnica. 2004
19. Scheiman MM, Hertle RW, Beck RW, Edwards AR, Birch E, Cotter SA, et al. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 2005;123(4):437-47
20. AAP, AACO, AAPOS, AAO. Eye examination in infants, children, and young adults by pediatricians. Pediatrics 2003;111(4 Pt 1):902-7
21. Williams C, Northstone K, Harrad RA, Sparrow JM, Harvey I. Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial. BMJ 2002;324:1-5
22. Eibschitz-Tsimhoni M, Friedman T, Naor J, Eibschitz N, Friedman Z. Early screening for amblyogenic risk factors lowers the prevalence and severity of amblyopia. JAAPOS 2000;4(4):194-9
23. Kvarnström G, Jakobsson P, Lennerstrand G. Visual screening of Swedish children: an ophthalmological evaluation. Acta Ophthalmol Scand 2001;79(3):240-4
24. Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2002;120(3):268-78
25. Chou R, Dana T, Bougatsos C. Screening for visual impairment in children ages 1-5 years: systematic review to update the 2004 U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No81, AHQR Publication No 11-05151-EF-1. February 2011
26. Høeg T, Moldow B, Ellervik C, Klemp K, Erngaard D, Lacour M, et al. Danish Rural Eye Study: the association of preschool vision screening with the Prevalence of amblyopia. Acta Ophthalmol. 2014:1-8
27. Gupta A, Lal R, Mazta SR, Sharma D, Author A, Department of Community Medicine I, et al. Prevalence of refractive errors, color vision defects and other ocular disorders in school-going children: Primary screening by school teachers. Journal International Medical Sciences Academy 2012;25(4):223-4
28. Group TViPS. Comparison of preschool vision screening tests as administered by licensed eye care professionals in the vision in preschoolers study Ophthalmology 2004;111(4):637-50
29. Williams C, Harrad RA, Harvey I, Sparrow JM, Author A, Dept O, et al. Screening for amblyopia in preschool children: Results of a population-based, randomised controlled trial. Ophthalmic Epidemiology 2001;8(5):279-95
30. Chang CH, Tsai RK, Sheu MM. Screening amblyopia of preschool children with uncorrected vision and stereopsis tests in Eastern Taiwan. Eye (London, England) 2007;21(12):1482-8
31. Ying G-s, Maguire M, Quinn G, Kulp MT, Cyert L, Vision In Preschoolers Study G. ROC analysis of the accuracy of Noncycloplegic retinoscopy, Retinomax Autorefractor, and SureSight Vision Screener for preschool vision screening. Investigative ophthalmology & visual science 2011;52(13):9658-64
32. Cooper CD, Gole GA, Hall JE, Colville DJ, Carden SM, Bowling FG. Evaluating photoscreeners II: MTI and fortune videorefractor. Australian and New Zealand journal of ophthalmology 1999;27(6):387-98
33. Mohan K, Saroha V, Sharma A. Successful Occlusion Therapy for Amblyopia in 11- to 15-Year-Old Children. J Pediatr Ophthalmol Strabismus 2004;41(2):89-95
34. Pediatric Eye Disease Investigator Group. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol 2011;129(11):1451-7
35. Cochrane Database of Systematic Reviews. Interventions for unilateral and bilateral refractive amblyopia. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005137.pub3/abstract
36. Pediatric Eye Disease Investigator Group. Treatment of Anisometropic Amblyopia in Children with Refractive Correction. Ophthalmology 2006;113(6):895-903
37. Chen P, Chen J, Tai M, Fu J, Chang C, Lu D. Anisometropic amblyopia treated with spectacle correction alone: possible factors predicting success and time to start patching. Am J Ophthalmol 2007;143(1):54-60
38. Pediatric Eye Disease Investigator Group. A Comparison of Atropine and Patching Treatments for Moderate Amblyopia by Patient Age, Cause of Amblyopia, Depth of Amblyopia, and Other Factors. Ophthalmology. 2003;110:1632-8
39. Pediatric Eye Disease Investigator Group. Two-year follow-up of a 6-month randomized trial of atropine vs patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2005;123:149-57
40. Pediatric Eye Disease Investigator Group. A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol 2003;121:603-11
41. Pediatric Eye Disease Investigator Group. A Randomized Trial of Atropine Regimens for Treatment of Moderate Amblyopia in Children. Ophthalmology 2004;111:2076-85
42. Pediatric Eye Disease Investigator Group. The course of moderate amblyopia treated whith atropine in children: experience of the amblyopia treatment study. Am J Ophthalmol 2003;136(630-639)
43. Pediatric Eye Disease Investigator Group. A Randomized Trial of Atropine versus Patching for Treatment of Moderate Amblyopia: Follow-up at 10 Years of Age. Arch Ophthalmol 2008;126(8):1039-44
44. Pediatric Eye Disease Investigator Group. A prospective pilot study of treatment of amblyopia in children 10 to <18 years old. Am J Ophthalmol 2004;137:581-3
45. Pediatric Eye Disease Investigator Group. Stability of Visual Acuity Improvement Following discontinuation of Amblyopia Treatment in Children 7 to 12 Years Old. Arch Ophthalmol 2007;125(5):655-9
46. Pediatric Eye Disease Investigator Group. Patching vs atropine to treat amblyopia in children aged 7 to 17 years: a randomized trial. Arch Ophthalmol 2008;126:1634-42
47. Repka M, Gallin P, Scholz R, Guyton D. Determination of optical penalization by vectographic fixation reversal. Ophthalmology 1985;92:1584-6
48. Zhao J, Lam D, Chen L, al. e. Randomized controlled trial of patching vs acupuncture for anisometropic amblyopia in children aged 7 to 12 years. Arch Ophthalmol 2010;128:1510-7
49. Lam G, Repka M, Guyton D. Timing of amblyopia therapy relative to strabismus surgery. Ophthalmology 1993;100:1751-6
50. Paysse E, Coats D, Hussein M, Bowes M, Koch D. Long-term Outcomes of Photorefractive Keratectomy for Anisometropic Amblyopia in Children. Ophthalmology 2006;113:169-76
51. Reese P, Weingeist T. Pars plana management of ectopia lentis in children. Arch Ophthalmol 1987;105:1202-4
52. Lam D, Zhao J, Chen L, Wang Y, Zheng C, Lin Q, et al. Adjunctive Effect of Acupuncture to Refractive Correction on Anisometropic Amblyopia. Ophthalmology 2011;118:1501-11
53. Li R, Young K, Hoenig P, Levi D. Perceptual Learning Improves Visual Performance in Juvenile Amblyopia. Invest Ophthalmol Vis Sci 2005;46:3161-8
54. Helveston E. Visual Training: Current Status in Ophthalmology. Am J Ophthalmol 2005;140:903-10
55. Pediatric Eye Disease Investigator Group. Treatment of bilateral refractive amblyopia in children three to less than 10 years of age. Am J Ophthalmol 2007;144:487-96
56. Pediatric Eye Disease Investigator Group. Optical Treatment of Strabismic and Combined Strabismic-Anisometropic Amblyopia. Ophthalmology 2012;119(1):150-8
57. Pediatric Eye Disease Investigator Group. The effect of amblyopia therapy on ocular aligment. J AAPOS 2005;9:542-5
58. Koc F, Ozal H, Yasar H, Firat E. Resolution in partially accomodative esotropia during occlusion treatment for amblyopia. Eye 2006;20:325-8
59. Hubel D, Wiesel T. Receptive fields and functional architecture of monkey striate cortex. J Physiol 1968;195:215-43
60. Tigges M, Boothe R, Tigges J, Wilson J. Competition between an aphakic and an occluded eye for territory in striate cortex of developing rhesus monkeys: cytochrome oxidase histochemistry in layer 4C. J Comp Neurol 1992;316:173-86
61. Holmes JM, Kraker R, Beck RW. Pediatric Eye Disease Investigator Group. A Randomized Trial of Prescribed Patching Regimens for Treatment of Severe Amblyopia in Children. Ophthalmology 2003;110:2075-87
62. Ron A, Nawratzki I. Penalization treatment of amblyopia: a follow-up study of two years in older children. J Pediatr Ophthalmol Strabismus 1982;19:137-9
63. Repka MX, Kraker R, Beck RW, Birch E, Cotter SA, Holmes JM, et al. Treatment of severe amblyopia with weekend atropine: Results from 2 randomized clinical trials. J AAPOS 2009;13:258-63
64. Pediatric Eye Disease Investigator Group. Pharmacologic Plus Optical Penalization Treatment for Amblyopia: Results of a Randomized Trial. Arch Ophthalmol 2009;127(1):22-30
65. Repka M, Ray J. The efficacy of optical and pharmacological penalization. Ophthalmology 1993;100:769-75
66. France T, France L. Optical Penalization Can Improve Vision After Occlusion Treatment. J AAPOS 1999;3:341-3
67. Repka MX. Acupuncture for anisometropic amblyopia. J AAPOS 2011;15(1):3-4
68. Evidence-Based Complementary and Alternative Medicine. A meta-analysis of randomized controlled trials on acupuncture for amblyopia. http://onlinelibrary.wiley.com/o/cochrane/cldare/articles/DARE-12013030866/frame.html
69. European Journal of Ophthalmology. Efficacy and tolerance of levodopa to treat amblyopia: a systematic review and meta-analysis (Provisional abstract). http://onlinelibrary.wiley.com/o/cochrane/cldare/articles/DARE-12013032395/frame.html
70. Schmucker C, Kleijnen J, Grosselfinger R, Riemsma R, Antes G, Lange S, et al. Effectiveness of early in comparison to late(r) treatment in children with amblyopia or its risk factors: a systematic review. Ophthalmic Epidemiol 2010;17(1):7-17
71. Holmes JM, Lazar EL, Melia BM, Astle WF, Dagi LR, Donahue SP, et al. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol 2011;129(11):1451-7
72. Saxena R, Puranik S, Singh D, Menon V, Sharma P, Phuljhele S. Factors predicting recurrence in successfully treated cases of anisometric amblyopia. Indian J Ophthalmol 2013;61(11):630-3
73. Pediatric Eye Disease Investigator Group. Randomized Trial to Evaluate Combined Patching and Atropine for Residual Amblyopia. Arch Ophthalmol 2011;129(7):960-2
74. The Pediatric Eye Disease Investigator Group. Risk of Amblyopia Recurrence After Cessation of Treatment. J AAPOS 2004;8:420-8
75. Pediatric Eye Disease Investigator Group. Factors Associated with Recurrence of Amblyopia on Cessation of Patching. Ophthalmology 2007;114:1427-32
76. Newsham D. A randomised controlled trial of written information: the effect on parental non-concordance with occlusion therapy. Br J Ophthalmol 2002;86:787-91
77. Norman P, Searle A, Harrad RA, Vedhara K. Predicting adherence to eye patching in children with amblyopia: an application of protection motivation theory. br J Health Psychol 2003;8:67-82
78. Tjiam A, Holtslag G, Vukovic E, Asjes-Tydeman W, Loudon S, Borsboom G, et al. An Educational Cartoon Accelerates Amblyopia Therapy and Improves Compliance, Especially among Children of Immigrants. Ophthalmology 2012;119:2393-401
79. Pradeep A, Proudlock F, Awan M, Bush G, Collier J, Gottlob I. An educational intervention to improve adherence to hig-dosage patching regimen for amblyopia: a randomised controlled trial. Br J Ophthalmol 2014;98(7):865-70
80. Tommila V, Tarkkanen A. Incidence of loss of vision in the healthty eye in amblyopia. Br J Ophthalmol 1981;65:575-7
81. American Academy Pediatrics and American Academy of Ophthalmology. Joint Policy Statement. Protective Eyewear four Young Athletes. 2003
82. Vinger P. Sports medicine and the eye care professional. J Am Optom Assoc 1998;69:395-413
83. Saunte J, Saunte M. 33 cases of airsoft gun pellet ocular injuries in Copenhagen, Denmark 1998-2002. Acta Ophthalmol Scand 2006;84:755-8
84. Kennedy E, Ng T, Duma S. Evaluating eye injury risk of airsoft pellet guns by parametric risk functions. Biomed Sci Instrum 2006;42:7-12
85. Endo S, Ishida N, Yamaguchi T. Tear in the trabecular meshwork caused by an airsoft gun. Am J Ophthalmol 2001;131:656-7
86. Fleischhauer J, Goldblum D, Frueh B, Koerner F. Ocular injuries caused by airsoft guns. Arch Ophthalmol. 1999;117:1437-9
87. Greven C, Bashinsky A. Circumstance and outcome of ocular paintball injuries. Am J Ophthalmol 2006;141:393
88. Listman D. Paintball injuries in children: more than meets the eye. Pediatrics 2004;113:e15-8
89. Hargrave S, D. W, C W. Complications of ocular paintball injuries in children. J Pediatr Ophthalmol Strabismus 2000;37:338-43
2. DeSantis D. Amblyopia. Pediatric clinics of North America 2014;61(3):505-18
3. Thompson JR, Woodruff G, Hiscox FA, Strong N, Minshull C. The incidence and prevalence of amblyopia detected in childhood. Public Health 1991;105(6):455-62
4. Figueroa LF. Astigmatism, a risk factor for amblyopia. 2004
5. Carrasquilla G, Pulido A, De la Hoz A, Mieth k, Muñoz O, Guerrero R, et al. Guía Metodológica para la elaboración de Guías de Práctica Clínica con Evaluación Económica en el Sistema General de Seguridad Social en Salud Colombiano-Versión completa final. Fundación Santa Fe de Bogotá – Centro de Estudios e Investigación en Salud 2014:1-312
6. AGREE, Next, Steps, Consortium. The AGREE II Instrument [Electronic version]. Consultado en marzo de 2014, de http://www.agreetrust.org. 2009
7. Marroquín G. Oftalmología Pediátrica: Guías de Manejo. Asociación Colompiana de Oftalmología Pediátrica y Estrabismo ACOPE. 2006
8. Sjostrand J, Abrahamsson M. Risk factors in amblyopia. Eye (Lond) 1990:(Pt 6):787-93
9. Puertas D, Gimeno A, Ruiz-Falcó M, Torrelo A, Ardila M, Celada M, et al. Hemangiomas gigantes hemifaciales y síndrome phace: alteraciones oculares asociadas. Acta Estrabológica 2000;(XXIX):15-20
10. Pascual M, Huang J, Maguire M, Kulp M, Quinn G, Ciner E, et al. Risk factors for amblyopia in the vision in preschoolers study. Ophthalmology 2014;.121(3):622-9.e1
11. Simons K. Amblyopia characterization, treatment, and prophylaxis. Surv Ophthalmol 2005;50(2):123-66
12. López J, Osandón D, Denk O, Stevenon R, Agurto R, Uauy A, et al. Prevalencia de patología oftalmológica en prematuros menores de un año de edad. Rev chil pediatr 2012;83(6):570-6
13. Ellis G, Frey T, Gouterman R. Myelinated nerve fibers, axial myopia, and refractory amblyopia: an organic disease. J Pediatr Ophthalmol Strabismus 1987;24(3):111-9
14. Moguel-Ancheita S, Orozco-Gómez L. Disfuncionalidad neuronal y psicomotora como resultado del retraso en el tratamiento de la ambliopía. Cir Cir 2007;75:481-9
15. Yang Q, Wen S, Smith G, Chen Y, Krewski D, Chen X, et al. Maternal cigarette smoking and the risk of pregnancy-induced hypertension and eclampsia. Int J Epidemiol 2006;35(2):288-93
16. Lan W, Zhao F, Li Z, Zeng J, Liu W, Lu J, et al. Validation and cost-effectiveness of a home-based screening system for amblyopia. Ophthalmology 2012;119(6):1265-71
17. Morales P, Alramadam M, Serrano B, Martínez F. Ambliopía Tabaco Alcohol. Rev Clín Med Fam 2010;3(1):57-60
18. Parra J, García R, Farran M, Cutillas M, March E, Herrero E, et al. Optometría. Manual de exámenes clínicos. Universitat Politecnica de Catalunya Iniciativa Digital Politecnica. 2004
19. Scheiman MM, Hertle RW, Beck RW, Edwards AR, Birch E, Cotter SA, et al. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 2005;123(4):437-47
20. AAP, AACO, AAPOS, AAO. Eye examination in infants, children, and young adults by pediatricians. Pediatrics 2003;111(4 Pt 1):902-7
21. Williams C, Northstone K, Harrad RA, Sparrow JM, Harvey I. Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial. BMJ 2002;324:1-5
22. Eibschitz-Tsimhoni M, Friedman T, Naor J, Eibschitz N, Friedman Z. Early screening for amblyogenic risk factors lowers the prevalence and severity of amblyopia. JAAPOS 2000;4(4):194-9
23. Kvarnström G, Jakobsson P, Lennerstrand G. Visual screening of Swedish children: an ophthalmological evaluation. Acta Ophthalmol Scand 2001;79(3):240-4
24. Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2002;120(3):268-78
25. Chou R, Dana T, Bougatsos C. Screening for visual impairment in children ages 1-5 years: systematic review to update the 2004 U.S. Preventive Services Task Force Recommendation. Evidence Synthesis No81, AHQR Publication No 11-05151-EF-1. February 2011
26. Høeg T, Moldow B, Ellervik C, Klemp K, Erngaard D, Lacour M, et al. Danish Rural Eye Study: the association of preschool vision screening with the Prevalence of amblyopia. Acta Ophthalmol. 2014:1-8
27. Gupta A, Lal R, Mazta SR, Sharma D, Author A, Department of Community Medicine I, et al. Prevalence of refractive errors, color vision defects and other ocular disorders in school-going children: Primary screening by school teachers. Journal International Medical Sciences Academy 2012;25(4):223-4
28. Group TViPS. Comparison of preschool vision screening tests as administered by licensed eye care professionals in the vision in preschoolers study Ophthalmology 2004;111(4):637-50
29. Williams C, Harrad RA, Harvey I, Sparrow JM, Author A, Dept O, et al. Screening for amblyopia in preschool children: Results of a population-based, randomised controlled trial. Ophthalmic Epidemiology 2001;8(5):279-95
30. Chang CH, Tsai RK, Sheu MM. Screening amblyopia of preschool children with uncorrected vision and stereopsis tests in Eastern Taiwan. Eye (London, England) 2007;21(12):1482-8
31. Ying G-s, Maguire M, Quinn G, Kulp MT, Cyert L, Vision In Preschoolers Study G. ROC analysis of the accuracy of Noncycloplegic retinoscopy, Retinomax Autorefractor, and SureSight Vision Screener for preschool vision screening. Investigative ophthalmology & visual science 2011;52(13):9658-64
32. Cooper CD, Gole GA, Hall JE, Colville DJ, Carden SM, Bowling FG. Evaluating photoscreeners II: MTI and fortune videorefractor. Australian and New Zealand journal of ophthalmology 1999;27(6):387-98
33. Mohan K, Saroha V, Sharma A. Successful Occlusion Therapy for Amblyopia in 11- to 15-Year-Old Children. J Pediatr Ophthalmol Strabismus 2004;41(2):89-95
34. Pediatric Eye Disease Investigator Group. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol 2011;129(11):1451-7
35. Cochrane Database of Systematic Reviews. Interventions for unilateral and bilateral refractive amblyopia. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD005137.pub3/abstract
36. Pediatric Eye Disease Investigator Group. Treatment of Anisometropic Amblyopia in Children with Refractive Correction. Ophthalmology 2006;113(6):895-903
37. Chen P, Chen J, Tai M, Fu J, Chang C, Lu D. Anisometropic amblyopia treated with spectacle correction alone: possible factors predicting success and time to start patching. Am J Ophthalmol 2007;143(1):54-60
38. Pediatric Eye Disease Investigator Group. A Comparison of Atropine and Patching Treatments for Moderate Amblyopia by Patient Age, Cause of Amblyopia, Depth of Amblyopia, and Other Factors. Ophthalmology. 2003;110:1632-8
39. Pediatric Eye Disease Investigator Group. Two-year follow-up of a 6-month randomized trial of atropine vs patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2005;123:149-57
40. Pediatric Eye Disease Investigator Group. A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol 2003;121:603-11
41. Pediatric Eye Disease Investigator Group. A Randomized Trial of Atropine Regimens for Treatment of Moderate Amblyopia in Children. Ophthalmology 2004;111:2076-85
42. Pediatric Eye Disease Investigator Group. The course of moderate amblyopia treated whith atropine in children: experience of the amblyopia treatment study. Am J Ophthalmol 2003;136(630-639)
43. Pediatric Eye Disease Investigator Group. A Randomized Trial of Atropine versus Patching for Treatment of Moderate Amblyopia: Follow-up at 10 Years of Age. Arch Ophthalmol 2008;126(8):1039-44
44. Pediatric Eye Disease Investigator Group. A prospective pilot study of treatment of amblyopia in children 10 to <18 years old. Am J Ophthalmol 2004;137:581-3
45. Pediatric Eye Disease Investigator Group. Stability of Visual Acuity Improvement Following discontinuation of Amblyopia Treatment in Children 7 to 12 Years Old. Arch Ophthalmol 2007;125(5):655-9
46. Pediatric Eye Disease Investigator Group. Patching vs atropine to treat amblyopia in children aged 7 to 17 years: a randomized trial. Arch Ophthalmol 2008;126:1634-42
47. Repka M, Gallin P, Scholz R, Guyton D. Determination of optical penalization by vectographic fixation reversal. Ophthalmology 1985;92:1584-6
48. Zhao J, Lam D, Chen L, al. e. Randomized controlled trial of patching vs acupuncture for anisometropic amblyopia in children aged 7 to 12 years. Arch Ophthalmol 2010;128:1510-7
49. Lam G, Repka M, Guyton D. Timing of amblyopia therapy relative to strabismus surgery. Ophthalmology 1993;100:1751-6
50. Paysse E, Coats D, Hussein M, Bowes M, Koch D. Long-term Outcomes of Photorefractive Keratectomy for Anisometropic Amblyopia in Children. Ophthalmology 2006;113:169-76
51. Reese P, Weingeist T. Pars plana management of ectopia lentis in children. Arch Ophthalmol 1987;105:1202-4
52. Lam D, Zhao J, Chen L, Wang Y, Zheng C, Lin Q, et al. Adjunctive Effect of Acupuncture to Refractive Correction on Anisometropic Amblyopia. Ophthalmology 2011;118:1501-11
53. Li R, Young K, Hoenig P, Levi D. Perceptual Learning Improves Visual Performance in Juvenile Amblyopia. Invest Ophthalmol Vis Sci 2005;46:3161-8
54. Helveston E. Visual Training: Current Status in Ophthalmology. Am J Ophthalmol 2005;140:903-10
55. Pediatric Eye Disease Investigator Group. Treatment of bilateral refractive amblyopia in children three to less than 10 years of age. Am J Ophthalmol 2007;144:487-96
56. Pediatric Eye Disease Investigator Group. Optical Treatment of Strabismic and Combined Strabismic-Anisometropic Amblyopia. Ophthalmology 2012;119(1):150-8
57. Pediatric Eye Disease Investigator Group. The effect of amblyopia therapy on ocular aligment. J AAPOS 2005;9:542-5
58. Koc F, Ozal H, Yasar H, Firat E. Resolution in partially accomodative esotropia during occlusion treatment for amblyopia. Eye 2006;20:325-8
59. Hubel D, Wiesel T. Receptive fields and functional architecture of monkey striate cortex. J Physiol 1968;195:215-43
60. Tigges M, Boothe R, Tigges J, Wilson J. Competition between an aphakic and an occluded eye for territory in striate cortex of developing rhesus monkeys: cytochrome oxidase histochemistry in layer 4C. J Comp Neurol 1992;316:173-86
61. Holmes JM, Kraker R, Beck RW. Pediatric Eye Disease Investigator Group. A Randomized Trial of Prescribed Patching Regimens for Treatment of Severe Amblyopia in Children. Ophthalmology 2003;110:2075-87
62. Ron A, Nawratzki I. Penalization treatment of amblyopia: a follow-up study of two years in older children. J Pediatr Ophthalmol Strabismus 1982;19:137-9
63. Repka MX, Kraker R, Beck RW, Birch E, Cotter SA, Holmes JM, et al. Treatment of severe amblyopia with weekend atropine: Results from 2 randomized clinical trials. J AAPOS 2009;13:258-63
64. Pediatric Eye Disease Investigator Group. Pharmacologic Plus Optical Penalization Treatment for Amblyopia: Results of a Randomized Trial. Arch Ophthalmol 2009;127(1):22-30
65. Repka M, Ray J. The efficacy of optical and pharmacological penalization. Ophthalmology 1993;100:769-75
66. France T, France L. Optical Penalization Can Improve Vision After Occlusion Treatment. J AAPOS 1999;3:341-3
67. Repka MX. Acupuncture for anisometropic amblyopia. J AAPOS 2011;15(1):3-4
68. Evidence-Based Complementary and Alternative Medicine. A meta-analysis of randomized controlled trials on acupuncture for amblyopia. http://onlinelibrary.wiley.com/o/cochrane/cldare/articles/DARE-12013030866/frame.html
69. European Journal of Ophthalmology. Efficacy and tolerance of levodopa to treat amblyopia: a systematic review and meta-analysis (Provisional abstract). http://onlinelibrary.wiley.com/o/cochrane/cldare/articles/DARE-12013032395/frame.html
70. Schmucker C, Kleijnen J, Grosselfinger R, Riemsma R, Antes G, Lange S, et al. Effectiveness of early in comparison to late(r) treatment in children with amblyopia or its risk factors: a systematic review. Ophthalmic Epidemiol 2010;17(1):7-17
71. Holmes JM, Lazar EL, Melia BM, Astle WF, Dagi LR, Donahue SP, et al. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol 2011;129(11):1451-7
72. Saxena R, Puranik S, Singh D, Menon V, Sharma P, Phuljhele S. Factors predicting recurrence in successfully treated cases of anisometric amblyopia. Indian J Ophthalmol 2013;61(11):630-3
73. Pediatric Eye Disease Investigator Group. Randomized Trial to Evaluate Combined Patching and Atropine for Residual Amblyopia. Arch Ophthalmol 2011;129(7):960-2
74. The Pediatric Eye Disease Investigator Group. Risk of Amblyopia Recurrence After Cessation of Treatment. J AAPOS 2004;8:420-8
75. Pediatric Eye Disease Investigator Group. Factors Associated with Recurrence of Amblyopia on Cessation of Patching. Ophthalmology 2007;114:1427-32
76. Newsham D. A randomised controlled trial of written information: the effect on parental non-concordance with occlusion therapy. Br J Ophthalmol 2002;86:787-91
77. Norman P, Searle A, Harrad RA, Vedhara K. Predicting adherence to eye patching in children with amblyopia: an application of protection motivation theory. br J Health Psychol 2003;8:67-82
78. Tjiam A, Holtslag G, Vukovic E, Asjes-Tydeman W, Loudon S, Borsboom G, et al. An Educational Cartoon Accelerates Amblyopia Therapy and Improves Compliance, Especially among Children of Immigrants. Ophthalmology 2012;119:2393-401
79. Pradeep A, Proudlock F, Awan M, Bush G, Collier J, Gottlob I. An educational intervention to improve adherence to hig-dosage patching regimen for amblyopia: a randomised controlled trial. Br J Ophthalmol 2014;98(7):865-70
80. Tommila V, Tarkkanen A. Incidence of loss of vision in the healthty eye in amblyopia. Br J Ophthalmol 1981;65:575-7
81. American Academy Pediatrics and American Academy of Ophthalmology. Joint Policy Statement. Protective Eyewear four Young Athletes. 2003
82. Vinger P. Sports medicine and the eye care professional. J Am Optom Assoc 1998;69:395-413
83. Saunte J, Saunte M. 33 cases of airsoft gun pellet ocular injuries in Copenhagen, Denmark 1998-2002. Acta Ophthalmol Scand 2006;84:755-8
84. Kennedy E, Ng T, Duma S. Evaluating eye injury risk of airsoft pellet guns by parametric risk functions. Biomed Sci Instrum 2006;42:7-12
85. Endo S, Ishida N, Yamaguchi T. Tear in the trabecular meshwork caused by an airsoft gun. Am J Ophthalmol 2001;131:656-7
86. Fleischhauer J, Goldblum D, Frueh B, Koerner F. Ocular injuries caused by airsoft guns. Arch Ophthalmol. 1999;117:1437-9
87. Greven C, Bashinsky A. Circumstance and outcome of ocular paintball injuries. Am J Ophthalmol 2006;141:393
88. Listman D. Paintball injuries in children: more than meets the eye. Pediatrics 2004;113:e15-8
89. Hargrave S, D. W, C W. Complications of ocular paintball injuries in children. J Pediatr Ophthalmol Strabismus 2000;37:338-43