Amblyopia as a Developmental Disorder

I have blogged before about the elegant vision science definition, introduced by Levi, of amblyopia as a developmental disorder of spatial vision, and our colleague Dr. Fortenbacher has summarized the impact of amblyopia on quality of life.

Two very practical articles are now available that shed more light on this, published in the journal JAAPOS.JAAPOS

The first article appeared in the August 2015 issue, and is titled: Reading rate and Scantron completion time in children with amblyopia.  We commonly see adolescents in our practice who are seeking accommodations on standardized testing.  Amblyopia is a condition that is traditionally defined by a reduction in visual acuity with one eye, and it has been felt – particularly in ophthalmologic circles – that an ADL such as filling in answers on a Scantron sheet should not be impacted as long as both eyes are being used.  This article by Birch and colleagues lends support to viewing amblyopia as a visual disorder that can negatively impact visual function with both eyes open despite good acuity and the absence of strabismus.


The second article is also by Birch and colleagues, this time with Kelly as the lead author, and absent John F. Gillmore III.  The article hasn’t come out in the print edition of JAAPOS yet, but is available online, and is titled: Amblyopic children read more slowly than controls under natural, binocular reading conditions.   Again, this is a population of students who have amblyopia without strabismus, and there are several noteworthy comments in the Discussion section:

a) Reading is a vision-reliant ability and slow reading can be detrimental to academic performance and learning.

b) Under natural, binocular silent reading conditions, school-age amblyopic children read slowly.

c) Slow reading in amblyopic children appears to be a consequence of  oculomotor dysfunction.

d) Parents and educators of  amblyopic children may be unaware that a child’s reading is affected by amblyopia because the child has 20/20 vision when tested binocularly.

e) It is important to provide academic accommodations for children with amblyopia when warranted, and not just for children with bilateral visual impairment.


In their acknowledgement to the article, the authors cite Kenneth Ciuffreda and  Preethi Thiagarajan for loaning a ReadAlyzer to them for training and pilot work.



8 thoughts on “Amblyopia as a Developmental Disorder

  1. And how do we convince pediatricians to actually screen for amblyopia and refer for treatment? Let me re-phrase that; how do we get general optometrists and pediatricians to actually screen for amblyopia and refer for treatment?

  2. Try developing general Optometrist as a source on a one to one basis by helping them with “unusual” cases that they see. REFER GENERAL WORK BACK TO THEM, ESPECIALLY BY NOT DISPENSING EYEWEAR.

  3. So interesting to see these conclusions to come out in a ophthalmological journal! Will they continue to ignore and treat just by patching? It would be great if one of our schools ran with this research and demonstrated improvements not just to monocular acuity but to reading speed utilizing vision therapy.

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