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. 1998 May;82(5):543–548. doi: 10.1136/bjo.82.5.543

An inner city preschool visual screening programme: long term visual results

R Bowman 1, T Williamson 1, R Andrews 1, T Aitchison 1, G Dutton 1
PMCID: PMC1722604  PMID: 9713063

Abstract

AIMS—The aim of this study was to investigate the long term outcome of the treatment of amblyopia as a sequel to preschool screening, which has not hitherto been described.
METHODS—All patients originally referred from a preschool screening programme were recalled for examination by letter. 255 patients were reviewed at least 4 years after discharge of which 88 were definitely amblyopic at presentation and 107 were not amblyopic at presentation and were used as controls.
RESULTS—79% of the amblyopes improved or maintained visual acuity after discharge but this was reduced to 42% after an age induced increase (estimated from the controls) was compensated for. The mean drop in visual acuity in the amblyopic eyes which deteriorated was 0.23 (SD 0.15) logMAR units. Stepwise multiple linear regression showed that the best single predictor of post-discharge deterioration in visual acuity was the improvement in visual acuity seen during treatment (R2 = 19%). Eccentric fixation at time of follow up (increasing R2 to 47%) and good presenting acuity (further raising R2 to 57%) contributed additional information, and were both associated with greater post-discharge deterioration in visual acuity.
CONCLUSIONS—The majority of amblyopes who attended for follow up maintained or improved their visual acuities after discharge. Those patients who demonstrated deterioration of their amblyopia had usually improved well during the programme and were often fixating eccentrically at follow up.

 Keywords: screening; amblyopia; children

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Figure 1  .

Figure 1  

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Scatter plot of follow up visual acuities against discharge visual acuities for the amblyopic eyes. Those eyes on or above the continuous line at least maintained their discharge acuity (79%) and those on or above the broken line showed at least the mean expected age related improvement (42%) which was 0.092 logMAR units calculated from the control group.

Figure 2  .

Figure 2  

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Individual patient profile plots of visual acuity of amblyopic eyes by time of measurement, for each diagnostic/fixation group at follow up

Figure 3  .

Figure 3  

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Box plots of visual acuity of amblyopic eyes by time of measurement, for each diagnostic group at follow up, with median traces. Outliers shown as *.

Figure 4  .

Figure 4  

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Scatter plot of post-discharge reduction in visual acuity against improvement in visual acuity during treatment. Upper right quadrant. Eyes which improved during treatment but deteriorated after discharge. The majority can be seen to be eccentric fixators at time of follow up. Lower right quadrant. Eyes which improved during treatment and at least maintained their acuity after discharge. The majority can be seen to be foveal fixators at time of follow up. Left hand quadrants. The few eyes which showed no improvement during treatment.

Figure 5  .

Figure 5  

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Distribution of stereoacuities in the amblyopia and control groups at follow up.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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