Clinical presentation

presentation

Presentation of amblyopia differs on whether it is unilateral or bilateral:

• unilateral loss
  • parents may not detect unless a visible condition such as strabismus is present
  • may result in failure to develop stereopsis (depth perception)
  • newborns may commonly present with variable ocular misalignment, but presence beyond the age of 3 months or constant misalignment requires further assessment
    
    
• bilateral loss
  • patient may present with
    • nystagmus
    • absence of 'eye contact'
    • delayed milestones of visual or motor development

Further assessment is recommended without delay in patients who do not reach visual developmental milestones e.g. –

• fixes and follows light source at 6 weeks
• smiles responsively at 6-8 weeks
• fixes and follows slowly moving objects or faces at 3 months
• reaches accurately for objects in visual environment at 6 months

Reference:

• (1) Jefferis JM, Connor AJ, Clarke MP. Amblyopia. BMJ. 2015;351:h5811