Clinical Profile and Visual Outcomes of Amblyopia in Children: A Retrospective Analysis from a Tertiary Care Centre in Northeast India
DOI:
https://doi.org/10.55489/njmr.160220261287Keywords:
Amblyopia, Pediatric visual impairment, Refractive errors, Occlusion therapy, Visual outcomes, Vision screeningAbstract
Background: Amblyopia is a leading cause of preventable visual impairment in children, with prognosis strongly influenced by etiology and age at intervention. Regional data from Northeast India remain limited, despite unique demographic and healthcare access challenges. The study conducted to evaluate the clinical profile, etiological distribution, and treatment outcomes of amblyopia among children attending a tertiary care centre in Northeast India, and to identify factors associated with visual improvement.
Methods: This retrospective observational study included children aged ≥3 years diagnosed with amblyopia between January 2023 and December 2025. Demographic details, clinical characteristics, refractive status, amblyopia subtype, and best-corrected visual acuity (BCVA) were recorded. Amblyopia was classified into anisometropic, iso-ametropic, strabismic, meridional, and stimulus deprivation types. Management included refractive correction with or without occlusion therapy following standard protocols. Visual improvement and treatment success were assessed using predefined BCVA criteria. Statistical analysis was performed to evaluate associations between clinical variables and outcomes.
Results: A total of 108 patients were analyzed, with a male predominance and a mean age at presentation in mid-childhood. Anisometropic amblyopia was the most common subtype, followed by iso-ametropic amblyopia. Refractive amblyopia demonstrated the most favorable response to treatment, whereas strabismic and stimulus deprivation amblyopia showed comparatively poorer outcomes. Younger age at presentation was significantly associated with higher treatment success, while gender and baseline severity showed no significant association.
Conclusion: Refractive amblyopia remains the predominant and most treatment-responsive form of amblyopia. Delayed presentation continues to limit optimal outcomes, particularly in non-refractive subtypes. Early detection through routine pediatric vision screening and timely intervention are essential to improve visual prognosis in children.
References
1. Blair K, Cibis G, Zeppieri M, et al. Amblyopia. [Updated 2024 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430890/
2. Hashemi H, Pakzad R MSc, Yekta A, Bostamzad P, et al. Global and regional estimates of prevalence of amblyopia: A systematic review and meta-analysis. Strabismus. 2018 Dec;26(4):168-183. DOI: https://doi.org/10.1080/09273972.2018.1500618 . PMID: 30059649.
3. Levi DM, Li RW. Improving the performance of the amblyopic visual system. Philos Trans R Soc Lond B Biol Sci. 2009;364(1515):399-407. DOI: https://doi.org/10.1098/rstb.2008.0203 PMid:19008199 PMCid:PMC2674474
4. Wallace DK; Pediatric Eye Disease Investigator Group; Edwards AR, Cotter SA, Beck RW, Arnold RW, Astle WF, Barnhardt CN, Birch EE, Donahue SP, Everett DF, Felius J, Holmes JM, Kraker RT, Melia M, Repka MX, Sala NA, Silbert DI, Weise KK. A randomized trial to evaluate 2 hours of daily patching for strabismic and anisometropic amblyopia in children. Ophthalmology. 2006 Jun;113(6):904-912. DOI: https://doi.org/10.1016/j.ophtha.2006.01.069 PMid:16751033 PMCid:PMC1609192
5. Ganekal S, Jhanji V, Liang Y, Dorairaj S. Prevalence and etiology of amblyopia in Southern India: results from screening of school children aged 5-15 years. Ophthalmic Epidemiol. 2013 Aug;20(4):228-231. DOI: https://doi.org/10.3109/09286586.2013.809772 PMid:23865603
6. Birch EE. Amblyopia and binocular vision. Prog Retin Eye Res. 2013 Mar;33:67-84. DOI: https://doi.org/10.1016/j.preteyeres.2012.11.001 PMid:23201436 PMCid:PMC3577063
7. Williams C, Northstone K, Harrad RA, Sparrow JM, Harvey I; ALSPAC Study Team. Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial. BMJ. 2002 Jun 29;324(7353):1549. DOI: https://doi.org/10.1136/bmj.324.7353.1549 PMid:12089090 PMCid:PMC116606
8. American Academy of Ophthalmology. Pediatric Ophthalmology and Strabismus. Basic and Clinical Science Course (BCSC). Section 6. San Francisco: AAO; 2023.
9. Repka MX, Beck RW, Holmes JM, Birch EE, Chandler DL, Cotter SA, Hertle RW, Kraker RT, Moke PS, Quinn GE, Scheiman MM; Pediatric Eye Disease Investigator Group. A randomized trial of patching regimens for treatment of moderate amblyopia in children. Arch Ophthalmol. 2003 May;121(5):603-11. DOI: https://doi.org/10.1001/archopht.121.5.603 PMid:12742836. PMID: 12742836.
10. Von Noorden GK, Campos EC. Binocular Vision and Ocular Motility. 6th ed. St. Louis: Mosby; 2002.
11. Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study. Ophthalmology. 2008 Jul;115(7):1229-1236.e1. DOI: https://doi.org/10.1016/j.ophtha.2007.08.001 PMid:17953989 PMCid:PMC4839485
12. Attebo K, Mitchell P, Cumming R, Smith W, Jolly N, Sparkes R. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998 Jan;105(1):154-159. DOI: https://doi.org/10.1016/S0161-6420(98)91862-0 PMid:9442792
13. Levi DM, Li RW. Improving the performance of the amblyopic visual system. Philos Trans R Soc Lond B Biol Sci. 2009 Feb 12;364(1515):399-407. DOI: https://doi.org/10.1098/rstb.2008.0203 PMid:19008199 PMCid:PMC2674474
14. Pai AS, Rose KA, Leone JF, Sharbini S, Burlutsky G, Varma R, Wong TY, Mitchell P. Amblyopia prevalence and risk factors in Australian preschool children. Ophthalmology. 2012 Jan;119(1):138-44. DOI: https://doi.org/10.1016/j.ophtha.2011.06.024. PMID: 21963268.
15. Donahue SP. Prescribing spectacles in children: a pediatric ophthalmologist's approach. Optom Vis Sci. 2007 Feb;84(2):110-114. DOI: https://doi.org/10.1097/OPX.0b013e318031b09b PMid:17299340
16. Harvey EM. Development and treatment of astigmatism-related amblyopia. Optom Vis Sci. 2009 Jun;86(6):634-639. DOI: https://doi.org/10.1097/OPX.0b013e3181a6165f PMid:19430327 PMCid:PMC2706277
17. Morgan IG, Ohno-Matsui K, Saw SM. Myopia. Lancet. 2012;379(9827):1739-1748. DOI: https://doi.org/10.1016/S0140-6736(12)60272-4 PMid:22559900
18. Worth CA. Squint: Its Causes, Pathology and Treatment. 4th ed. London: Baillière, Tindall and Cox; 1903.
19. Pediatric Eye Disease Investigator Group; Cotter SA, Foster NC, Holmes JM, Melia BM, Wallace DK, Repka MX, Tamkins SM, Kraker RT, Beck RW, Hoover DL, Crouch ER 3rd, Miller AM, Morse CL, Suh DW. Optical treatment of strabismic and combined strabismic-anisometropic amblyopia. Ophthalmology. 2012 Jan;119(1):150-158. DOI: https://doi.org/10.1016/j.ophtha.2011.06.043 PMid:21959371 PMCid:PMC3250558
20. Holmes JM, Lazar EL, Melia BM, Astle WF, et al. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol. 2011 Nov;129(11):1451-1457. DOI: https://doi.org/10.1001/archophthalmol.2011.179 PMid:21746970 PMCid:PMC3217111
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