FREQUENCY OF ANISOMETROPIC AMBLYOPIA AMONG CHILDREN: A CROSS-SECTIONAL STUDY

Abstract

Background: Amblyopia is a leading cause of preventable visual impairment in children and remains a major contributor to unilateral visual loss worldwide. It commonly arises from anisometropia, strabismus, or visual stimulus deprivation, with anisometropia recognized as a frequent and often underdiagnosed cause. Delayed identification during the sensitive period of visual development may result in persistent visual deficits, emphasizing the importance of early detection and population-specific data.

Objective: To determine the frequency of anisometropic amblyopia among children aged 5–15 years presenting to tertiary care ophthalmology clinics.

Methods: A descriptive cross-sectional study was conducted from October 2023 to January 2024 in the Ophthalmology outpatient departments of the University of Lahore Teaching Hospital and LRBT Hospital, Lahore, Pakistan. A total of 88 children aged 5–15 years were enrolled using a convenience sampling technique. Visual acuity was assessed monocularly using a Snellen chart at 6 meters. Children with visual acuity ≤6/12 in either eye or an interocular difference of ≥2 Snellen lines underwent cycloplegic refraction using 1% cyclopentolate. Bruckner reflex assessment and fundus examination were performed with a direct ophthalmoscope to confirm the diagnosis and exclude organic pathology. Data were recorded on a structured proforma and analyzed descriptively.

Results: Among the 88 participants, 49 were females (55.7%) and 39 were males (44.3%). Anisometropic amblyopia was identified in 68 children (77.3%), followed by strabismic amblyopia in 14 (15.9%) and stimulus deprivation amblyopia in 6 (6.8%). The highest proportion of amblyopia cases was observed in the 8–10-year age group (30.7%). Visual acuity values were distributed as follows: 0.30 in 5 children (5.7%), 0.48 in 21 (23.9%), 0.60 in 22 (25.0%), 0.78 in 22 (25.0%), and 1.00 or less in 18 children (20.5%). Mixed astigmatism (38.6%) and hyperopia (35.2%) were the most frequently associated refractive errors. Moderate and severe amblyopia were each observed in 41 children (46.6%).

Conclusion: Anisometropic amblyopia was the most prevalent form of amblyopia among children aged 5–15 years, particularly in the 8–10-year age group, highlighting the need for early vision screening and timely refractive correction to prevent long-term visual impairment.