June 2006

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Detecting "lazy eye" in preschoolers

A simple three-second office screening test may enable pediatricians to identify amblyopia, or vision loss in one eye, in children as young as 2, report Children's Hospital Boston researchers in the April Archives of Ophthalmology.

Amblyopia affects 3 to 5 percent of children and is caused by underuse of one eye, usually due to a misalignment (strabismus) or weaker focusing power (anisometropia). If the problem is detected early, patching the stronger eye or blurring it with drops can prevent vision loss. However, amblyopia is frequently missed in preschool-age children, who often can't communicate or read eye charts, and whose eyes can appear normal, says David Hunter, MD, PhD, Children's chief of Ophthalmology. Once a child reaches school age, treatment is less effective.

So Dr. Hunter developed a hand-held, laser-based screening instrument. Tested in 77 children, it identified all 37 children with strabismus and all three with anisometropia. About a quarter of these children, including the three with anisometropia, were 2 to 4 years old. All 37 controls passed the screening test. Dr. Hunter plans to field-test a refined device in pediatricians' offices within two years.


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