Diagnostic criteria for amblyopia in children

  Amblyopia is a common eye disease in children that seriously affects the development of visual function, and if not treated early, it can affect the formation of normal vision in children in the future. At the recently concluded 2010 National Strabismus and Amblyopia and Pediatric Ophthalmology Annual Meeting, experts from the group redefined amblyopia after listening to opinions from all walks of life.  In 1987, the Strabismus and Pediatric Ophthalmology Group of the Chinese Medical Association’s Ophthalmology Branch established the diagnostic criteria for amblyopia as a diagnosis with no organic lesions on ophthalmologic examination and corrected visual acuity below 0.9.  Amblyopia is redefined as: visual development caused by monocular strabismus, uncorrected refractive error, high refractive error, and form deprivation. Amblyopia classification: 1. Strabismic amblyopia: monocular strabismus Amblyopia caused by monocular strabismus.  2. Refractive amblyopia: 1.5DS difference between the two eyes and 1.0DC difference between the hyperopic spherical lens and the column lens, which can cause amblyopia to form in one eye with a higher refractive error.  3, refractive amblyopia: mostly occurs in patients with high refractive error who have not worn refractive correction glasses. Mainly seen in both eyes with high hyperopia or astigmatism, the best corrected visual acuity of both eyes is equal or similar. It is generally believed that hyperopia ≥ 5.00DS and astigmatism ≥ 1.0DC will increase the risk of amblyopia.  4, form deprivation amblyopia: caused by deprivation factors such as refractive interstitial clouding and ptosis, amblyopia can be unilateral or bilateral, unilateral is more serious than bilateral.  Suggestions for visual acuity testing methods: Different visual acuity scales are used for different ages, and graphic visual acuity scales are recommended for ages 3-5. Less than 3 years old can use PL, OKN, VEP, single letter visual acuity chart, and pay attention to the qualitative examination of the difference in visual acuity between the two eyes.  According to the previous diagnostic criteria, there are about 10 million amblyopic children in China. According to the new standards, more than one-third of China’s amblyopic children will be “removed”, which can effectively reduce the problem of expanding the diagnosis of amblyopia in children. Ophthalmologists point out that the old standards focused only on the child’s visual acuity and ignored the age factor, and many children were labeled as “amblyopic,” which had a serious impact on the child’s body and mind, as well as his or her family. The development of human vision, like the development of other organs in the body, is a gradual process, with newborn babies only having light perception and their vision reaching 1.0 at the age of 5, just like normal adults. The new criteria take full account of the characteristics of children’s visual development, making the diagnosis of amblyopia more accurate and comprehensive, while avoiding over-expansion of the amblyopia diagnosis. In addition, amblyopia is a problem during the period of visual development, and early detection and timely treatment can lead to reversal of amblyopic eyes. Therefore, establishing an early vision screening mechanism, strictly screening visual acuity and visual function from early birth, and correcting their refractive errors will greatly reduce the incidence of amblyopia.  The present modification does not mean that the original criteria have changed, but rather that on the basis of the original criteria, it is recommended that we should refer to various factors, and if the corrected visual acuity of children in the age group does not reach 0.9, we should give more observation time to this group of children and use other auxiliary examinations to help confirm the diagnosis for these children. This is just an additional suggestion. The new criteria will need some time to be tested and adjusted.