Amblyopia: Detection and Treatment.

Amblyopia is the leading cause of monocular vision loss in children. Early recognition and treatment are important to prevent vision loss. The U.S. Preventive Services Task Force recommends vision screening for all children at least once between three and five years of age to detect the presence of amblyopia or its risk factors. The American Association for Pediatric Ophthalmology and Strabismus and the American Academy of Pediatrics recommend routine, age-appropriate red reflex testing, examination for signs of strabismus, and vision chart testing. Photoscreening may be a useful adjunct to traditional vision screening, but there is limited evidence that it improves visual outcomes. Treatments for amblyopia include patching, atropine eye drops, and optical penalization of the nonamblyopic eye. In children with moderate amblyopia, patching for two hours per day is as effective as six hours, and daily atropine is as effective as daily patching. Children younger than seven years receive the most benefit from treatment, but older children may still benefit. Amblyopia recurs in 25% of children, so continued surveillance is important.