Amblyopia and the pediatrician

Abstract

Amblyopia is one of the most common eye ailments in children. Early treatment can frequently eliminate this problem. The responsibility for early recognition falls primarily on the pediatrician. The following summarizes what ought to be done for each age group to rule out amblyopia and its associated conditions. Newborn to age four months--Make sure the eyes appear normal externally and have a clear red reflex (no cataracts). Infants after age four months--Check fixation of each eye with a penlight. Check for symmetrical corneal light reflexes. Also check red reflex and fundus. Be aware of a positive family history. Age four--Visual acuity in each eye should be measured. Ideally all children should be referred for a complete eye examination and refraction if this is economically feasible. School age--Check vision yearly. If a person is going to have one complete routine eye examination by an ophthalmologist in the first half of his lifetime, checking him at age four years would be ideal. It should include a cycloplegic refraction to rule out excessive farsightedness, nearsightedness, astigmatism or unequal refraction in the two eyes. This should be done by a person thoroughly schooled in recognizing eye diseases rather than by a nonmedical practitioner. Annual eye examinations by an ophthalmologist are probably unnecessary if the visual acuity is good and the child is asymptomatic.