The functional impact of amblyopia

Abstract

Amblyopia is the most common disorder managed in paediatric ophthalmic practice in industrialised countries. Reports on the impact of amblyopia on tasks relevant to the activities of children, or on skills pertinent to their education and quality of life, is leading to greater understanding of the functional disabilities associated with the condition. This review considers the extent to which amblyopia affects the ability to carry out everyday tasks, with particular attention to studies of motor skills and reading proficiency in children. Collectively, these studies show that amblyopia results in poorer outcomes on tests of skills required for proficiency in everyday tasks and which relate to childhood academic performance. However, the relative contributions that the documented vision anomalies inherent in amblyopia contribute to various functional disabilities is not fully determined. Recent reports have demonstrated improvement following treatment in standardised measures of fine motor skills involved in practical, everyday tasks. Including measurement of functional performance skills in amblyopia treatment trials is desirable to show treatment effect on crucial, real-world activities.

Functional limitations recognised by adults with amblyopia and strabismus in daily life: a qualitative exploration

“…This could be because of the impairments in performing manual dexterity tasks with speed and accuracy. 16,17,40 It is interesting to note that many of our study findings (e.g. difficulties in driving, reading, using stairs, walking) are similar to a previous study which explored the quality of life in adults with diplopic and non-diplopic strabismus 41 ; nevertheless, our study focussed on amblyopia (with or without strabismus) and provides a more exhaustive qualitative narrative.…”

“…[10][11][12][13][14][15][16] In addition, experimental studies have demonstrated functional impacts in the performance of real-life tasks such as reading, driving and reaching and grasping. [16][17][18] However, it is not clear whether these deficits translate into functional limitations that are recognised by individuals themselves in normal everyday situations.…”

Effects of simulated anisometropia and aniseikonia on stereopsis

“…The images from the two eyes are combined in the visual cortex, where the disparity is processed to produce awareness of the relative depth of objects. The ability to perceive depth assists functional performance, particularly for judging depth and for assisting visually directed motor activity 2,3 . For example, visually guided in‐depth hand movements take longer and are less accurate under monocular compared to binocular viewing in visually normal subjects, 5–7 and walking speed is about 10% slower under monocular rather than binocular conditions 8 …”

Impacto da ambliopia estrabísmica e anisometrópica na visão de cores e de contraste espacial com diferentes níveis de complexidade

“…Indivíduos com ambliopia com frequência têm opções de carreira restritas e redução da qualidade de vida, incluindo menor contato social, questões cosméticas quando a ambliopia é associada ao estrabismo, problemas de autoestima, desorientação visual e ansiedade em perder a visão do outro olho (Van De Graaf et al 2004, Carlton and Kaltenthaler 2011, Wong 2012, Webber 2018, Birch et al 2019b).…”

“…Esses déficits visuais são também encontrados no olho não afetado (Levi and Klein 1985, Wong, Levi and McGraw 2001, Mansouri, Allen and Hess 2005, Kiorpes, Tang and Movshon 2006, Levi 2008, Hayward et al 2011 tanto processamentos corticais locais como globais (Levi 2007, Mansouri and) e envolvem extração e segregação de um sinal do ruído de fundo (Levi, Klein and Sharma 1999, Norcia et al 2005, Popple and Levi 2000, claramente, implicando em processos visuais de alta ordem (Webber 2018).…”