To compare distant visual acuity (DVA) and near visual acuity (NVA) in amblyopia and evaluate if NVA can be used to diagnose amblyopia. A retrospective study was performed on 73 patients diagnosed with amblyopia based on DVA, by measuring their NVA and comparing the DVA and NVA. The NVA was measured by Snellen chart at 30 cm and the DVA was measured by Dr Hahn vision test chart at 5m. The patients’ age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, and prism diopter (PD) were evaluated and their relationship with the difference between the DVA and NVA was analyzed. The NVA was significantly better than the DVA in amblyopia ( P = .000). The difference between the DVA and NVA was not significantly related to the type of amblyopia ( P = .600) or the patients’ age( P = .351). Also, the difference between the DVA and NVA was not significantly affected by the spherical equivalent ( P = .425) or the difference between spherical equivalent and the fellow eye spherical equivalent ( P = .212) in anisometropia amblyopia, and also not by the PD ( P = .882) in strabismus amblyopia. In amblyopes, the NVA was better than the DVA before amblyopia treatment. The difference between the DVA and NVA was not affected by age, type of amblyopia, spherical equivalent, the difference between spherical equivalent and the fellow eye spherical equivalent spherical, or PD. Therefore, it should be taken into consideration that NVA could underestimate the severity of amblyopia and affect the accuracy at diagnosing amblyopia.

Purpose: To investigate clinical symptoms and visual outcome in patients who had presumed congenital cataract with visual acuity ≥20/200. Methods: Twenty-nine patients (50 eyes) ranging in age from 5-28 years were included in this study. Congenital cataract was diagnosed by patients' past history, previous medical records, and typical findings of congenital cataract. Inclusion criteria were patients with visual acuity measured by Snellen chart, best corrected visual acuity ≥20/200, and no eye or systemic diseases influencing visual acuity. Seven patients had unilateral cataracts and 22 patients had bilateral cataracts. Cataracts were nuclear in 29 eyes, anterior or posterior subcapsular in 12 eyes, and polar in 7 eyes. All patients underwent lens aspiration or phacoemulsification combined with posterior chamber intraocular lens (PC-IOL) implantation without performing intentional posterior capsulotomy and anterior vitrectomy. Results: The most common clinical symptom was visual disturbance followed by blurred vision, glare and knitting the brow, strabismus, and leukocoria. Comparison of calculated PC-IOL power showed a more significant myopic shift in unilateral cataract than in bilateral cataract. Postoperative best corrected visual acuity >20/25 was attained in 28 (65.1%) eyes with bilateral cataracts and 1 (14.3%) eye with a unilateral cataract. Conclusions: Cataract surgery is effective not only in improving visual acuity but also in eliminating clinical symptoms. Delaying cataract surgery in early infancy should be considered to avoid intentional operative procedures in patients with bilateral congenital cataract preserving visual acuity >20/200. Journal of Pediatric Ophthalmology and Strabismus 2000;37:219-224.