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Updated: Aug 30, 2026
The Measurement and Treatment of Suppression in Amblyopia
Published on: December 14, 2012
Services provided for preschool-aged children with suspected amblyopia
Alex R Kemper1, Sarah J Clark, Gary L Freed
1Child Health Evaluation and Research Unit, Division of General Pediatrics, University of Michigan, Ann Arbor, Michigan 48109-0456, USA.
Insights
Pediatric eye care varies between optometrists and ophthalmologists for young children. Optometrists see more preschool patients, but ophthalmologists routinely dilate eyes more often during initial evaluations.
Area of Science:
- Ophthalmology
- Optometry
- Pediatric Eye Care
Background:
- Limited understanding of care patterns for preschool children with abnormal vision screening results.
- Variations in pediatric eye care services are not well-documented.
Purpose of the Study:
- Evaluate variations in pediatric eye care services for preschool-aged patients.
- Assess optometrist and ophthalmologist availability, referral patterns, and perceived barriers to care.
Main Methods:
- Survey distributed to 542 ophthalmologists and 501 optometrists in Michigan.
- Response rate: 65% (75% optometrists, 57% ophthalmologists).
Main Results:
- Optometrists evaluated more preschool children (97%) than ophthalmologists (79%).
- Both managed amblyopia and strabismus, but ophthalmologists routinely dilated eyes more (93% vs 39%).
- Leading barrier: examination difficulty (25% vs 23%). Referral sources differed: community/self-referral for optometrists, primary care for ophthalmologists.
Conclusions:
- Optometrists and ophthalmologists have distinct referral sources and care approaches for preschool children.
- While both treat common conditions like amblyopia, differences in practice exist.
- Further research needed on outcome and cost impacts; findings should inform screening programs.
Background:
Little is known about the pattern and variation of care offered to preschool-aged children who have had an abnormal vision screening test.
Purpose:
To evaluate the variations in pediatric eye care services and availability of optometrists and ophthalmologists for preschool-aged patients, referral patterns, and barriers to providing care as perceived by eye care specialists.
Methods:
A survey was mailed to 542 ophthalmologists and a random sample of 501 optometrists actively practicing in Michigan.
Results:
The response rate was 65% (optometrists, 75%; ophthalmologists, 57%). More optometrists than ophthalmologists evaluated preschool-aged children (97% vs 79%; P < .001). Of these, most managed amblyopia (80% vs 77%; P = .372) and strabismus (89% vs 80%; P = .002) themselves. Fewer optometrists than ophthalmologists dilated eyes routinely during the first evaluation of a preschool-aged child (39% vs 93%; P < .001). The leading barrier to care for preschool-aged children reported by both optometrists and ophthalmologists was difficulty of the examination (25% vs 23%; P = .501). Optometrists reported that most of their patients were referred from community-based screening programs or by parent self-referral. Ophthalmologists reported that most of their preschool-aged patients were referred from primary care providers.
Conclusions:
There are different sources of referrals for optometrists and ophthalmologists. Although most eye care specialists treat amblyopia, the types of care offered by optometrists and ophthalmologists differ. Future studies should address the impact that these patterns have on outcomes and cost. The results of these studies should be shared with those responsible for screening.
