Brazilian best practice guidelines for amblyopia diagnosis and management

Dayane Cristine Issaho¹; Júlia Dutra Rossetto²; Ian Curi³; Roberta Zagui⁴; Luis Carlos Sá⁴; Iara Debert⁴; Aline Brasileiro Pena⁵; Lais Yumi Sakano⁶; Marcia Keiko Uyeno Tabuse⁷; Luisa Moreira Hopker¹

DOI: 10.5935/0004-2749.2023-0281

ABSTRACT

This study aimed to propose a guideline for amblyopia treatment and follow-up. Studies show that amblyopia leads to a series of perceptual deficits, including loss of visual acuity, stereoacuity, and contrast sensitivity. Perceptual changes are also found in the sound eye, such as those involving the types of motion perception. The gold standard of treatment remains the prescription of eyeglasses, when indicated, and patching of the dominant eye. The treatment is mostly effective in patients aged <7 years and must be discontinued gradually, tapering off patching for at least 5 weeks. Atropine may be performed for penalization in hyperopic children whose amblyopic eye has better visual acuity under cycloplegia than the fellow eye. The discovery of significant neural plasticity in the amblyopic brain after the critical period opens possibilities for new treatment modalities even after childhood.

Keywords: Amblyopia; Atropine; Contrast sensitivity; Motion perception; Eyeglasses; Visual acuity; Prescriptions

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