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Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children?

Abstract：

PURPOSE:To report the prevalence of amblyopia risk factors in children with congenital nasolacrimal duct obstruction. METHODS:A retrospective review of records of children with the diagnosis of congenital nasolacrimal duct obstruction (NLDO), who underwent probing from January 2009 to October 2011, was done. All of them underwent a complete ophthalmic evaluation including cycloplegic refraction and strabismus evaluation before probing. RESULTS:A total of 142 children were included in this study. The mean age at presentation was 22.38 months (sample standard deviation (SSD) - 15.88). Amblyopia risk factors were defined according to two sets of guidelines: The American Association for Pediatric Ophthalmology and Strabismus (AAPOS) referral criteria guidelines and the new AAPOS Vision Screening Committee guidelines. Twenty-eight (20%) children were found to have some form of amblyopia risk factor based on the referral criteria prescribed by AAPOS. However, on applying modified guidelines described by Donahue et al., to analyze the same cohort, 21 children were found to have amblyogenic risk factors. Of these 28 children, 13 had significant astigmatism (>1.50 D), 8 children had hypermetropia (>3.50 D), and six children had anisometropia (>1.50 D). One child had significant cataract (media opacity >1 mm). None of the children in this series had either myopia or strabismus. CONCLUSION:Prevalence of amblyopia risk factor was found to be 20% in our study based on the older guidelines; however, it reduces to 14.78% by applying the modified guidelines. Despite this reduction, importance of a comprehensive ophthalmic examination including cycloplegic refraction in all children presenting with NLDO cannot be overstated. A close follow-up of these children is also essential to prevent the development of amblyopia.

journal_name

Indian J Ophthalmol

journal_title

Indian journal of ophthalmology

authors

Ramkumar VA,Agarkar S,Mukherjee B

doi

10.4103/0301-4738.190101

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

496-9

issue

eissn

0301-4738

issn

1998-3689

pii

IndianJOphthalmol_2016_64_7_496_190101

journal_volume

pub_type

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Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children?