PURPOSE: To evaluate clinical characteristics of posterior lenticonus associated with pediatric cataracts and to identify the factors associated with final visual acuities after cataract surgery. METHODS: Thirty-eight patients (46 eyes) who were diagnosed with posterior lenticonus preoperatively or during the operation were involved in this study. We investigated the age at diagnosis, the severity of lens opacity, the pre- and postoperative best corrected visual acuity, and the effectiveness of amblyopia treatment. RESULTS: The mean age at presentation was 39.0+/-37.4 months, and the mean follow-up period was 42.8+/-33.5 months postoperatively. Nine patients (23%) had bilateral posterior lenticonus, and the mean age of bilateral cases was lower (p<0.001) and the lens opacity more severe than those of unilateral cases (P=0.001). Fifteen eyes (32.6%) were surgically identified as having posterior lenticonus during lens aspiration, the mean age of surgically identified cases was lower (p<0.001) and the lens opacity more severe then those of preoperatively diagnosed cases (P=0.014). The age at initial examination was negatively correlated with final visual acuities in log MAR (P=0.04). CONCLUSIONS: Bilateral and surgically identified posterior lenticoni were associated with younger age and more severe lens opacity. The final visual acuities were better in patients with late onsets of lens opacities.
Amblyopia ; Cataract* ; Diagnosis ; Follow-Up Studies ; Humans ; Visual Acuity

PURPOSE: The aim of this study was to compare sensory and motor functions in patients with constant and intermittent primary infantile exotropia. METHODS: From March 2010 to November 2015, 58 patients with primary infantile exotropia were divided into a constant group (21 patients) and an intermittent group (37 patients) according to frequency of exodeviation at the first visit. Sex, family history of strabismus, age at diagnosis, spherical equivalent, and presence of amblyopia were compared. Angle of deviation, ocular motor function, and stereopsis were measured. RESULTS: Females were more prevalent (p = 0.027) and the spherical equivalent of the right eye was more myopic (-0.99 D) (p = 0.023) in the constant infantile exotropia group. However, there was no significant difference in family history of strabismus, age at diagnosis, amblyopia, latent nystagmus, or stereopsis between the two groups. There were no significant differences between the two groups in angle of deviation at near or distance (p = 0.598, p = 0.518). Dissociated vertical deviation was accompanied in 2 patients in the constant group and 3 in the intermittent group. Inferior oblique overaction was accompanied in 8 patients in the constant group and 16 in the intermittent group, while vertical deviation was accompanied in 1 patient in the constant group and 3 in the intermittent group. However, there were no significant differences between the groups for any of these findings. CONCLUSIONS: Constancy of exodeviation is insufficient to diagnose primary infantile exotropia. Compared to those in whom exodeviation was intermittent, the patients with constant infantile exotropia showed similar clinical features. Therefore, close observation is recommended in patients with intermittent and constant infantile exotropia.
Amblyopia ; Depth Perception ; Diagnosis ; Exotropia* ; Female ; Humans ; Strabismus

Good compliance of patching therapy is essential to improve visual acuity in amblyopia. The author investigated the compliance and effective method of occlusion therapy for amblyopia by questionair given to the patients and their parents. For better compliance and the duration of patching and the best time for its performance should be controlled according to patients' character and age. It was shown that the younger the age, the better the compliance of patching therapy. It was important that early diagnosis for amblyopia made and early treatment should be initiated before 6 years of age, beeause the compliance of patching therapy was much decreased in patients above six years of age. Physicians should ensure full understanding of amblyopia in patients and their parents, especially mothers, before patching therapy begins. Continued and steady patching could considerably improve visual acuity in ehildren older than eight years of age.
Amblyopia* ; Compliance* ; Early Diagnosis ; Humans ; Mothers ; Parents ; Visual Acuity

We assessed the potential clinical usefulness of pattern-visual evoked potentials (=PVEP) in the diagnosis of amblyopia. 15 children with bilateral amblyopia, 64 children with unilateral amblyopia and 11 children without amblyopia participated. After estimating of visual acuity for each eye. PVEP were also obtained. Of the 15 bilateral amblyopic children 12 (80%) showed abnormally lower amplitudes than normal children and amplitudes of the rest 3 patients were in normal range and their visual acuity were relatively upper range, 0.5-0.6. Of the 64 unilateral amblyopic children 4 of 9(44.4%) children who had 2 line difference of interocular visual acuity, 2 of 3(67.7%) children who had 3 line difference and all children except 1 who had 4 or more line difference(99.9%) showed abnormal interocular amplitude difference ratio(=IADR). As a result, bilateral and unilateral amblyopia can be identified by PVEP amplitude and IADR and abnormal IADR shows that interocular visual acuity differences is over 3-4 lines. We thought that PVEP could be used to find the amblyopic eye and monitor the effect of treatment in preverbal children also.
Amblyopia* ; Child* ; Diagnosis ; Evoked Potentials ; Humans ; Reference Values ; Visual Acuity

In children with horizontal strabismus, we observed and analysed binocular fixation pattern (BFP) pf each eye and the results of BFP were compared with visual acuity of each eye to evaluate the effect of BFP examination for diagnosis of the preferred eye. In BFP of the esotropes and intermittent exotropes with or without amblyopa, most of patients showed grade I of BFP in the preferred eyes and grade IV of BFP in the non-preferred eyes. The exotropes showed no significant amblyopia, and BFP of the preferred eyes were variable from grade I to IV while most of the non-preferred eyes showed grade IV of BFP. In the patients with visual improvement after occlusion therapy, about half of them showed an improvement in BFP. Therefore, the preferred and non-preferred eyes may be distinctive according to BFP in strabismic patients with amblyopia or not. The measurement of BFP may be an eefective method for diagnosis of the preferred eye in children with horizontal strabismus if it is combinded with the examination for visual acuity.
Amblyopia ; Child* ; Diagnosis ; Humans ; Strabismus* ; Telescopes* ; Visual Acuity

In children with horizontal strabismus, we observed and analysed binocular fixation pattern (BFP) pf each eye and the results of BFP were compared with visual acuity of each eye to evaluate the effect of BFP examination for diagnosis of the preferred eye. In BFP of the esotropes and intermittent exotropes with or without amblyopa, most of patients showed grade I of BFP in the preferred eyes and grade IV of BFP in the non-preferred eyes. The exotropes showed no significant amblyopia, and BFP of the preferred eyes were variable from grade I to IV while most of the non-preferred eyes showed grade IV of BFP. In the patients with visual improvement after occlusion therapy, about half of them showed an improvement in BFP. Therefore, the preferred and non-preferred eyes may be distinctive according to BFP in strabismic patients with amblyopia or not. The measurement of BFP may be an eefective method for diagnosis of the preferred eye in children with horizontal strabismus if it is combinded with the examination for visual acuity.
Amblyopia ; Child* ; Diagnosis ; Humans ; Strabismus* ; Telescopes* ; Visual Acuity

PURPOSE: The purpose of this study is to provide useful clinical information for proper diagnosis of the superior oblique muscle palsy (SOP) associated with horizontal deviation. METHODS: The records of 186 patients with SOP treated surgically were reviewed. The patients who underwent surgery for horizontal deviation more than 10 PD were classified into SOP associated with horizontal deviation. RESULTS: Of 186 patients with SOP, 96 (51.6%) patients also showed horizontal deviation. In 59 patients (61.5%) of these 96 patients, chief complaint was horizontal deviation only and 24 patients (25.0%) knew their hyperdeviation. Compensatory head-tilt was shown in 52 patients (54.2%), however only 11 (11.5%) patients complained their head-tilt posture. Of 96 patients, 72 (82.3%) had horizontal deviation in the eye contralateral to the paretic eye and amblyopia occurred in the horizontally deviated eye. The frequency of exodeviation was 82.3 % and was more than that of esodeviation. The mean amount of hyperdeviation was 12.6 +/- 6.77 PD, and that of horizontal deviation was 22.9 +/- 8.13 PD in exodeviation and 22.5 +/- 9.17 PD in esodeviation, respectively ninety three patients (96.9%) showed positive Bielschowsky head-tilt test. All 83 patients who had fundus examination showed foveal extorsion. CONCLUSIONS: This study reveals that Bielschowsky head-tilt test and fundus examination for foveal extorsion are needed to diagnose SOP which is masked by prominent horizontal deviation.
Amblyopia ; Diagnosis ; Esotropia ; Exotropia ; Humans ; Masks ; Paralysis ; Posture

PURPOSE: To evaluate the clinical interpretation and application of Teller Acuity Card(TAC) test compared with optotype acuity chart in the diagnosis of amblyopia. METHODS: The visual acuities of 112 children(54 normal, 58 amblyopes), whose mean age was 6.5 years(3~11 years) were measured with Han's letter chart and TAC. The sensitivity, specificity, false-positive and false-negative rates of TAC Test were analyzed according to the visual acuity, age and type of amblyopia. RESULTS: TAC acuity was higher than optotype acuity in both strabismic and anisometropic amblyopia group, however, the anisometropic amblyopia group showed higher correlation between two tests(P<0.01,r=0.0755). The sensitivity and specificity of TAC test increased in lower visual acuity group, which means that TAC test is useful in detecting amblyopia. While the false-positive rate increased in higher visual acuity group, false-negative rate increased in lower visual acuity group and in the group less than 6 years of age. And the bilateral visual acuity were underestimated than unilateral visual acuity in about 30%. CONCLUSIONS: Though TAC test is a useful method in detecting amblyopia of infancy and childhood, an appropriate clinical diagnosis should be accompanied for the accurate diagnosis of amblyopia.
Amblyopia* ; Anisometropia ; Diagnosis* ; Sensitivity and Specificity ; Strabismus ; Visual Acuity

OBJECTIVETo test the effects of corrective spectacles in hyperopic amblyopic children with heterophoria.

METHODSVisual acuity, refraction and the amount of heterophoria on near (33 cm) fixation were measured before and after 3 weeks of spectacle-wearing in 30 hyperopic amblyopic children with heterophoria. The control group consisted of 20 emmetropic children age-matched to the patients.

RESULTSUncorrected eyes displayed hyperopic amblyopia accompanied by heterophoria. Corrective spectacles not only attenuated the hyperopia and amblyopia, but also changed the heterophoria to orthophoria. The amount of heterophoria before wearing spectacles was significantly different from that in emmetropic children; but after correction with spectacles, it was the same as that in the emmetropic controls.

CONCLUSIONCorrection with spectacles is effective for the treatment of heterophoria in hyperopic children with amblyopia.

Accommodation, Ocular ; Amblyopia ; diagnosis ; therapy ; Child ; Eyeglasses ; Humans ; Hyperopia ; diagnosis ; therapy ; Refraction, Ocular ; Vision Tests ; methods

PURPOSE: The treatment for reverse amblyopia is to discontinue occlusion therapy with most cases showing improvement of visual acuity in the dominant eye. Herein, we report a case of reverse amblyopia after monocular cataract surgery which was refractory to treatment and showed strabismus. CASE SUMMARY: A 3-month-old female was diagnosed with congenital cataract in her left eye and underwent aspiration of lenses, posterior capsulectomy, and anterior vitrectomy. After the surgery, her mother performed strict 6:1 occlusion therapy on her right eye as prescribed. The best corrected visual acuity measured for the first time at the age of 32 months was 1.70 in the right eye and 0.52 in the left eye and the patient was referred to the Pediatric Ophthalmology clinic. At that time, eccentric fixation with slight exotropia was observed. With the diagnosis of reverse amblyopia in the right eye, the occlusion therapy was postponed for several months, however, visual acuity in the right eye did not recover after 4 months. After the age of 3 years, she was treated with left eye occlusion therapy, but the vision was still low and eccentric fixation was observed. At the age of 5 years she was continuously treated with left eye occlusion and the eccentric fixation improved, and at 6 years of age, a secondary intraocular lens implantation was performed. At 9 years of age, the patient underwent lateral rectus recession and medial rectus resection in the right eye for the treatment of exotropia. CONCLUSIONS: In the case of monocular congenital cataract, occlusion therapy should be prescribed after surgical treatment. However, because reverse amblyopia which is refractory to treatment can occur, the fixation pattern should be monitored carefully and the occlusion duration controlled appropriately.
Amblyopia* ; Cataract ; Diagnosis ; Exotropia ; Female ; Humans ; Infant ; Lens Implantation, Intraocular ; Mothers ; Ophthalmology ; Strabismus ; Visual Acuity ; Vitrectomy