Comparison of amblyopia in schoolchildren in Ireland and Northern Ireland: a population-based observational cross-sectional analysis of a treatable childhood visual deficit

What is it about?

What is already known on this topic:

Amblyopia (lazy eye) is a relatively common, treatable vision deficit that affects between 1% and 5% of the population. The treatment window for amblyopia is age-related, and unless treatment is completed early in childhood (before age 8), amblyopia may lead to life-long visual impairment, impacting the quality of life, educational progress and career choice.
Amblyopia is primarily caused by strabismus (misaligned eyes), anisometropia (a significant difference in prescription between fellow eyes) or a high prescription in both eyes (high levels of astigmatism or hyperopia), or a combination of these features. In general, amblyopia affects only one eye, which means that when a child’s eyes are straight, even severe amblyopia often goes unnoticed by parents.
In Ireland and NI, publicly funded vision screening programmes to detect reduced vision are carried out at school entry (age 4-5 years) to detect amblyopia when treatment is still possible.

What this study adds:
This study is the first population-based study to report amblyopia prevalence in Ireland and NI. Children in Ireland were four times more likely than children in NI to have amblyopia beyond the traditional treatment period, which was associated with poor compliance with spectacle wear and socioeconomic disadvantage. Children living in Ireland, where school-entry vision screening coverage is less comprehensive, free eye care less accessible, and long treatment waiting times exist, had a higher prevalence of amblyopia. While most children in Ireland with visible eye defects such as strabismus (misaligned eyes) were treated, children without obvious visible eye defects were less likely to access eye-care in Ireland resulting in missed opportunities for intervention where necessary. Future studies examining the reasons for poor spectacle compliance in Ireland compared to NI are recommended.

Featured Image