Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children.
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Date
2016-07
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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.
Description
Keywords
Amblyopia risk factors, anisometropia, congenital nasolacrimal duct obstruction
Citation
Ramkumar V Akila, Agarkar Sumita, Mukherjee Bipasha. Nasolacrimal duct obstruction: Does it really increase the risk of amblyopia in children. Indian Journal of Ophthalmology. 2016 July; 64(7): 496-499.