Clinical Perceptions and Practice Patterns for Amblyopia in Korea

Jeong Woo Kang; Seon Ha Bae; Nam Ju Moon

doi:10.3341/jkos.2020.61.2.190

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Kang, Bae, and Moon: Clinical Perceptions and Practice Patterns for Amblyopia in Korea

Original Article

Journal of the Korean Ophthalmological Society 2020; 61(2): 190-199.

Published online: 18 February 2020

DOI: https://doi.org/10.3341/jkos.2020.61.2.190

Clinical Perceptions and Practice Patterns for Amblyopia in Korea

Jeong Woo Kang, MD, Seon Ha Bae, MD, Nam Ju Moon, MD, PhD

Department of Ophthalmology, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.

Address reprint requests to Nam Ju Moon, MD, PhD. Department of Ophthalmology, Chung-Ang University Hospital, #102 Heukseok-ro, Dongjak-gu, Seoul 06973, Korea. Tel: 82-2-6299-1666, Fax: 82-2-825-1666, njmoon@cau.ac.kr

Received 2 August 2019 Revised 4 November 2019 Accepted 22 January 2020

The Korean Ophthalmological Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

We used a questionnaire to explore perceptions and clinical practice patterns of Korean pediatric ophthalmologists in terms of amblyopia.

Methods

From September to November 2018, we conducted a web-based questionnaire survey of 99 specialists of the Korean Association for Pediatric Ophthalmology and Strabismus who operated ophthalmology clinics in Korea. We received 56 responses (56.57%) and retrospectively analyzed the data.

Results

The average specialist age was 44.0 ± 9.7 years. The mean age of treated amblyopia patients was 3 to 5 years (69.6%); the most common amblyopia was refractive anisometropic amblyopia (75.0%). On average, treatment commenced at 4 years of age (53.6%); child and parent co-operation most significantly influenced treatment success (46.4%). The preferred test was cycloplegic refraction (96.4%) and the preferred treatment occlusion therapy (100%) with glasses correction (98.2%). Occlusion therapy was most commonly performed for 2 hours/day (69.6%); the minimum age for eyeglasses prescription was 2.10 ± 1.18 years. Only three respondents (5.36%) prescribed contact lenses and only one (1.79%) performed refractive surgery.

Conclusions

In Korea, amblyopia treatment is based on occlusion therapy and glasses correction. However, the time of treatment commencement, the duration of occlusion therapy, and the glasses used for correction varied. It is necessary to develop guidelines for amblyopia treatment; these should reflect current medical conditions.

Keywords: Amblyopia, Clinical practice patterns, Survey study

Figures and Tables

Figure 1

Clinical features of amblyopic children. The mean age of the patients treated was 3 to 5 years old (69.6%), and the most common cause of the amblyopia was refractive anisometropic amblyopia (75.0%). On average, treatment began at 4 years of age (53.6%) and the respondents cited that the cooperation of parents and children as the most important factor affecting their treatment success (46.4%).

Figure 2

Preferred diagnostic tools for amblyopia (multiple response: n = 56). In the multiple responses to preferred diagnostic tools, 54 out of 56 respondents (96.4%) said that they performed the cycloplegic refraction test, and 45 (80.4%) said that they performed the alternative cover test. Thirty five (62.5%) chose to take the manifest refraction, 25 (44.6%) chose auto refraction. But stereopsis test (18, 32.1%) and post-cycloplegic refraction (12, 21.4%) showed relatively low selection rates.

Figure 3

Preferred treatment methods. In the survey of scoring between 1 and 5 points for treatments methods, most respondents answered that patching and refractive correction were very effective or effective, with 4.64 points. Next, the penalization was effective or slightly effective with 2.79 points, and many said contact lenses (1.77 points) and refractive surgery (1.46 points) were ineffective or unclear.

Figure 4

Preferred patching time. In a question about the time to patch, 2 hours per day method was the largest with 69.6%, while 6 hours per day method was the second most with 41.1%.

Table 1

Basic characteristics of respondents

In a survey of 99 respondents, a total of 56 responded, with a response rate of 56.57%. Among the respondents, 26 men (46.42%), 30 women (53.57%), and the average age was 44.0 ± 9.7 years. Values are presented as mean ± standard deviation or number (%).

Table 2

Preferred diagnostic tools for amblyopia (multiple response)

In the multiple responses to preferred diagnostic tools, 54 out of 56 respondents (96.4%) said that they performed the cycloplegic refraction test, and 45 (80.4%) said that they performed the alternative cover test. 35 (62.5%) chose to take the manifest refraction, 25 (44.6%) chose auto refraction. But stereopsis test (18, 32.1%) and post-cycloplegic refraction (12, 21.4%) showed relatively low selection rates. Values are presented as number (%).

Table 3

Subjective scoring of treatment effects

In the survey of scoring between 1 and 5 points for treatments methods, most respondents answered that patching and refractive correction were very effective or effective, with 4.64 points. Next, the penalization was effective or slightly effective with 2.79 points, and many said contact lenses (1.77 points) and refractive surgery (1.46 points) were ineffective or unclear. Values are presented as mean ± standard deviation.

Table 4

Criteria for the prescription of glasses in amblyopic child

Table shows the prescribing patterns for amblyopic child, according to the type of refractive errors. Most respondents prescribed glasses to amblyopic child at age of 2.10 years. Values are presented as mean ± standard deviation.

D = diopters.

Notes

This study was presented as a poster at the 121th Annual Meeting of the Korean Ophthalmological Society.

^{Conflicts of Interest} The authors have no conflicts to disclose.

Appendix

Appendix 1

Questionnaires sheets. The questionnaire consisted of general information of the survey participants, the status of the amblyopic child and the treatment of the patients.

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