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Distribution and Patterns of Refractive Errors in a Pediatric Amblyopic Cohort Aged 3-5 Years: A Descriptive Study in
Syeda Filzah Bukhari1, Farah Akhtar1, Hira Ghafar Shah1
1Department of Ophthalmology, Al Shifa Trust Eye Hospital, Rawalpindi, Punjab, Pakistan.
Insights
Astigmatism is a common cause of amblyopia in young children, with specific patterns observed in males and females. Early detection through preschool screening is crucial for preventing vision loss.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Refractive Errors
Background:
- Amblyopia, or 'lazy eye,' affects visual development in children.
- Refractive errors are a significant cause of amblyopia.
- Understanding refractive error patterns in amblyopic children is vital for early intervention.
Purpose of the Study:
- To determine the types and severity of refractive errors in Pakistani children aged 3-5 years with amblyopia.
- To identify patterns of refractive errors contributing to amblyopia in this age group.
Main Methods:
- Cross-sectional study of 178 children (3-5 years) with refractive amblyopia.
- Comprehensive ophthalmic examination including cycloplegic refraction.
- Analysis of refractive errors using MEPEDS criteria and SPSS.
Main Results:
- Astigmatism was the most prevalent refractive error (53.4%), particularly myopic and hyperopic astigmatism.
- Gender-specific patterns were noted: females more prone to myopia/astigmatism, males to hyperopia/astigmatism.
- Astigmatic errors were associated with poorer visual acuity and greater amblyopia severity.
Conclusions:
- Astigmatic refractive errors are strongly linked to amblyopia severity.
- Early identification of amblyogenic refractive error patterns is essential for timely intervention.
- Preschool screening is recommended to prevent irreversible vision loss and support WHO goals.
Purpose:
To assess the patterns and severity of different refractive errors in children aged 3 to 5 years presenting with established amblyopia in a tertiary care eye centre in Pakistan.
Patients And Methods:
A cross-sectional study was conducted at a tertiary care eye center involving 178 children (aged 3-5 years). The study specifically included only those with refractive amblyopia; children with strabismic or sensory deprivation amblyopia were excluded. From each participant, only the amblyopic eye (or the eye with the worse visual acuity in bilateral cases) was analyzed to ensure statistical independence. All participants underwent a comprehensive ophthalmic examination, including cycloplegic refraction (using 1% cyclopentolate) and dilated fundus evaluation. Refractive errors were classified according to MEPEDS criteria, and data was analyzed using SPSS version 24.0.
Results:
Among the 178 amblyopic eyes, astigmatism (53.4%) was common, particularly myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%). Females were more likely to have myopia or astigmatism, whereas males were more likely to have hyperopia or astigmatism which may indicate some gender-specific patterns in amblyopia. Hyperopia was mostly low to moderate, while moderate astigmatism was more common than high astigmatism. These differences were also statistically significant (p < 0.001). Amblyopes with myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%) exhibited the poorest visual acuity (mean LogMAR VA 1.05 ± 0.49 and 0.96 ± 0.46).
Conclusion:
Astigmatic refractive errors are more likely associated with greater amblyopia severity, and even lower thresholds of refractive error have the potential to cause amblyopia. By establishing these amblyogenic patterns, our study provides the surveillance data essential for early intervention. These findings advocate for preschool screening to prevent irreversible vision loss, directly advancing the WHO SPECS 2030 goal of people-centered eye care.
