ICO International Clinical Guidelines:
Amblyopia (Initial and Follow-up Evaluation)
(You can also download this Guideline as a PDF file - 110 KB)
More on the Guidelines:
On this page:
- Initial exam history
- Initial physical exam
- Care management
- Follow-up evaluation
- Amblyopia follow-up evaluation intervals during active
treatment period
- Patient education
Initial Exam History (Key elements)
- Ocular symptoms and signs [A:III]
- Ocular history [A:III]
- Systemic history, including review of prenatal, perinatal, and postnatal medical factors [A:III]
- Family history, including eye conditions and relevant systemic diseases [A:III]
Initial Physical Exam (Key elements)
- Examination of visual acuity and fixation pattern [A:III]
- Ocular alignment and motility [A:III]
- Red reflex or binocular red reflex (Brückner) test [A:III]
- Pupil examination [A:III]
- External examination [A:III]
- Anterior segment examination [A:III]
- Cycloplegic retinoscopy/refraction [A:III]
- Funduscopic examination [A:III]
- Binocularity/stereoacuity testing [A:III]
Care Management
- Choose treatment based on patient's age; visual acuity; compliance with previous treatment; and physical, social, and psychological status. [A:III]
- Treatment goal is to achieve equalization/normalization of fixation patterns or visual acuity. [A:III]
- Once maximal visual acuity has been obtained, treatment should be tapered and eventually stopped. [A:III]
Follow-up Evaluation
- Follow-up visits should include:
Amblyopia Follow-up Evaluation Intervals During Active Treatment Period (A:III)
|
Age (years) |
High Percentage Occlusion (70% or more of waking hours/>6 hours per day) |
Low Percentage Occlusion (<70% of waking hours/<6 hours per day) or Penalization |
Maintenance Treatment or Observation |
|
0-1 |
1-4 weeks |
2-8 weeks |
1-4 months |
|
1-2 |
2-8 weeks |
2-4 months |
2-4 months |
|
2-3 |
3-12 weeks |
2-4 months |
2-4 months |
|
3-4 |
4-16 weeks |
2-6 months |
2-6 months |
|
4-5 |
4-16 weeks |
2-6 months |
2-6 months |
|
5-7 |
6-16 weeks |
2-6 months |
2-6 months |
|
7-9 |
8-16 weeks |
3-6 months |
3-12 months |
Patient Education
- Discuss diagnosis, severity of disease, prognosis and treatment plan with patient, parents and/or caregivers. [A:III]
- Explain the disorder and recruit the family in a collaborative approach to therapy. [A:III]
* Adapted from the American Academy of Ophthalmology Summary Benchmarks, November 2008 (www.aao.org)
(You can also download this Guideline as a PDF file - 110 KB)
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