Suggested Searches
Care
View All
Locations
View All
Providers
View All
General Results

Consult

Clinician-to-Clinician Update
To schedule a consultation, referral or appointment
(888-543-7866) or 612-365-8350 (Minneapolis), 952-892-2920 (Burnsville), 763-898-1004 (Maple Grove)

Ophthalmology

Specialty Clinic for Children – Burnsville
Ridgeview Medical Building
303 E. Nicollet Blvd., Suite 372
Burnsville, MN 55337

Minnesota Lions Children’s Eye Clinic
Park Plaza Building
701 25th Ave. S., Floor 3
Minneapolis, MN 55454

Eye Care - Pediatrics
University of Minnesota Health Maple Grove Clinics
14500 99th Ave. N., Floor 1, Desk A
Maple Grove, MN 55369

Addressing Amblyopia and Vision Disorders in Young Children

Amblyopia affects an estimated 1% to 6% of children in the United States.1,2,3 The condition is usually unilateral and can stem from 3 causes: strabismus; obstruction of the visual axis, such as by congenital cataracts; or anisometropia, with unequal refraction resulting from varying degrees of astigmatism, myopia, or hyperopia in each eye.4 A disorder in the development of vision rather than an eye disease, amblyopia arises when differing or unaligned visual signals cause the visual cortex to suppress the affected eye’s image. Uncorrected amblyopia results in vision loss in the affected eye ranging from mild (worse than 20/50) to severe (legal blindness with visual acuity of 20/200 or worse).4,5 

Patients with amblyopia are often asymptomatic.4,5 Very young children may not express any awareness of vision problems, but they may also squint or cover one eye, signaling a possible vision problem.6 Those affected by strabismus may appear to have a deviated gaze. 

Early screening is important, since vision development occurs early in life, concluding about age 8. If undetected and untreated before 8 years of age, the condition may become irreversible.5,6 Photoscreening is useful for screening young children and relies on the use of a camera to record pupillary reflexes during testing. Pre- and postreflex images can then be compared to detect differences and prompt referral to an eye doctor.4,5 

Treatment for amblyopia is individualized, depending on the disorder’s cause, and must also address any underlying conditions.4 Experienced team-based eye care improves outcomes. Therapy commonly employs patching or using atropine drops to blur vision in the unaffected eye, which forces the brain to focus on the visual signal from the amblyopic eye and drives improved visual development.4,5 For strabismus, cataracts, and ptosis, surgical procedures can correct defects, while eyeglasses or contact lenses can address refractive errors. In younger children, compliance with therapy is often an issue; however, newer techniques offer promise. When moderate amblyopia is treated before age 7, research indicates, most patients regain good visual acuity, although mild residual amblyopia is common.7 (See Case Study for further discussion.) 

Pediatric ophthalmologists with University of Minnesota Health, in addition to treating a high volume of pediatric patients, are testing new approaches to amblyopia in a clinical trial that involves spectacles and video game play. The trial explores whether video games may improve therapeutic compliance in young patients compared to traditional treatments with atropine drops or patching.8 (See Pediatric Specialty Updates.) The physicians’ recent research also extends to improving treatment for ophthalmologic disorders, including mitigating complications in surgical repair of strabismus9 and implementing therapies for rare and genetic eye disorders that have no well-defined therapies.10 

References

  1. Tarczy-Hornoch K, Cotter SA, Borcher M, et al. Prevalence and causes of visual impairment in Asian and non-Hispanic white preschool children: Multi-Ethnic Pediatric Eye Disease Study. Ophthalmology. 2013;120(6):1220-1226. 
  2. McKean-Cowdin R, Cotter SA, Tarczy-Hornoch K, et al. Prevalence of amblyopia or strabismus in Asian and non-Hispanic white preschool children: Multi-Ethnic Pediatric Eye Disease Study. Ophthalmology. 2013;120(10):2117-2124. 
  3. Ying G-S, Maguire MG, Cyert LA, et al. Prevalence of vision disorders by racial and ethnic group among children participating in Head Start. Ophthalmology. 2014;121(3):630-636. 
  4. Bradfield YS. Identification and treatment of amblyopia. Am Fam Physician. 2013;87(5):348-352. 
  5. Hunter D, Cotter S. Early diagnosis of amblyopia. Vis Neurosci. 2018 Jan; 35:E013. 
  6. Jonas DE, Amick HR, Wallace IF, et al. Vision screening in children aged 6 months to 5 years: evidence report and systematic review for the U.S. Preventive Services Task Force. JAMA. 2017;318(9):845-858. 
  7. Repka MX, Kraker RT, Holmes JM, et al. Atropine vs. patching for treatment of moderate amblyopia: follow-up at 15 years of age of a randomized clinical trial. JAMA Ophthalmol. 2014;132(7):799-805. 
  8. Holmes JM, Manny RE, Lazar EL, et al. A randomized trial of binocular Dig Rush game treatment for amblyopia in children aged 7 to 12 years. Ophthalmology. 2019;126(3):456-466. 
  9. Areaux RG Jr, Maltry AC. Chronic inflammatory granulomata after use of GenTeal gel during strabismus surgery. JAAPOS. 2018;22(6):473-475. 
  10. Strul S, Straughn P. Successfully improving visual acuity in keratitis-ichthyosis-deafness syndrome utilizing gas-permeable lenses: a case report. Eye Contact Lens. 2018;44(Suppl 1):S330-S332.

When to refer

The University of Minnesota Health team of pediatric ophthalmologists, orthoptists, and staff works together closely to examine and treat children for vision problems and other eye disorders. Our providers coordinate with other physicians who specialize in treating oculoplastic, corneal, and retinal disorders in children. Our team also includes optometrists and specialists in contact lens fitting. 

We have one of the largest pediatric ophthalmology programs in the United States, and more than 10,000 children are treated annually by our ophthalmologists at our specialty care clinics in the Twin Cities metropolitan area. 

Our integrated pediatric services include eyeglasses fitting, medication prescription, and surgical and nonsurgical therapies. We offer specialized screening exams and tumor treatment, including screening for retinopathy of prematurity (ROP). Our care team provides treatment for amblyopia, strabismus, esotropia, exotropia, cataracts, glaucoma, ptosis, ROP, neuro-ophthalmological disorders, orbital malformations, retinal and genetic eye diseases, and many other conditions. 

We collaborate with colleagues in neurology, oncology, neonatology, genetics, rheumatology, dermatology, and other disciplines to provide care for patients with complex or multiple eye conditions. As participants in academic medicine, we also conduct research into new treatments and provide access to clinical trials for eligible patients. 

For consultation or referral, contact us at 612-365-8350 (Minneapolis), 952-892-2920 (Burnsville), or 763-898-1004 (Maple Grove). 

To find current clinical trials available through University of Minnesota Health providers: studyfinder.umn.edu

To download a free copy of the Mothers' and Children's Specialty Directory, visit mhealth.org/childrens-directory.

Subscribe to our mailing list

* indicates required

Send me information on:
University of Minnesota Health Service Commitment

Access to our Expertise
We are available to consult about your patients, with or without referral.

Appointment Access
Our goal, whenever possible, is to see your patient within 5 days if requested.

Follow-Up Communication
You will hear from us within a week after your patient is seen.

24/7 Referrals
Through our Physician Referral Service, you can make a referral, request a consult, or admit a patient through our main number: 888-318-3627 (Adults) or 888-543-7866 (Pediatrics)

If you have feedback about Consult, please contact us at consult@mhealth.org.