The aim of the study was to highlight the medical and legal difficulties in framing lowvision patients for certification. We performed a retrospective observational study conducted from January 2013 to January 2016, on 63 patients with the mean age of 16.37±3.34 years, evaluated at the Ophthalmology Clinic from "Sf. Spiridon" Hospital, Iași, in order to release a medical certificate required at the Expertise Board. The clinical parameters observed were visual acuity (VA) with correction, objective refraction (in Spherical Equivalent -SEq), intraocular pressure, slit lamp examination of the anterior pole, fundus examination, orthoptic eye exam, and ocular ultrasonography (in selected cases). The main causes for the decreased visual acuity found are refractive or strabic amblyopia determined by: high myopia (28.57%), esotropia (19.04%), astigmatism (17.46); congenital diseases -congenital nystagmus (12.69%), congenital cataract (7.93%), microphthalmia (7.93%); acquired diseases -retinopathy of prematurity (9.52%), optic nerve atrophy (7.93%), bandelette keratopathy (6.34); ocular trauma (7.93%). In 52.38% of the cases for the RE and 53.96% of the cases for the LE, decreased visual acuity was caused by an irreversible condition and could not be improved. Patients come every year for reevaluation in order to receive the medical certificate required at the Expertise Board. Evaluating the patient for a certificate for visual impairment is a time consuming process due to the high number of investigations necessary and, sometimes, difficult collaboration with the patient with associated general pathology. It also requires knowledge of frequently changing legislation to complete legal forms for patients with visual impairment. A medical certificate may now be issued with a validity of up to four years, given that certain diseases are irreversible and visual functional status does not change over time.

Purpose To asses the quality of life for children with anisometropic amblyopia. Methods A retrospective study for 53 children (33 girls and 20 boys) performed in ambulatory clinic in 2010. The average age at first diagnosis is 7.1415 ± 2.9317 years old (limits between 2 and 16 years). During the study the average age of children is 9.4943 ± 3.8422 years (limits between 3 and 20 years). Tracking interval is 1 year in 33.95%, between 2 and 5 years in 60.37% and over 5 years in 5.64%. Clinical parameters observed are: sex, age, visual acuity, optical correction, the type of correction (glasses, contact lenses), strabismic deviation and genetic factor. Results Uncorrected visual acuity average at the right eye is 0.4353 ± 0.3640 and for the left eye is 0.3934 ± 0.3158. Corrected visual acuity average at the right eye is 0.6626 ± 0.3552 and for the left eye is 0.6468 ± 0.3519. Mean objective refraction (in spherical equivalent) at the right eye is ‐5.8214 ± 4.4651 and ‐5.52 ± 5.89 for the left eye. The average cylinder value is ‐0,7783 ± 1,1671 (with a range between maximum = ‐4.75 and minimum = ‐1). For 60.37% of patients, cylinder value is less than 0,75. There is a genetic transmission in 23.21% of cases, predominantly in mother (9.43%) and sister (9.43%). In 39.62% of cases there was esotropia. For 11.32% of cases, optical correction was made with contact lenses. Conclusion 1. As early the diagnosis of anisometropia is made, visual acuity is more easily recovered. 2. The average age of diagnosis in the our cases is 7.1415 ± 2.9317, noting that in Romania children are late diagnosed. 3. It is required a collaboration between the pediatrician, an ophthalmologist and the family for an early diagnosis of refraction errors. 4. Anisometropic amblyopia can be corrected using contact lenses.