Strabismic Amblyopia: When to Treat the Amblyopia, When to Operate

Introduction: Strabismic amblyopia is frequently encountered by pediatric ophthalmologists and orthoptists. An understanding of its onset and of the timing of treatment may lead to better long-term treatment results. Methods: A review was conducted of past and recent literature pertaining to strabismic amblyopia. Articles relevant to further understanding the onset, course, and management of strabismic amblyopia were included. Results: The timing of suggested surgical alignment and amblyopia treatment in the literature has shifted. In contrast to recommendations of the past, it is now more accepted to perform strabismus surgery as soon as possible, in conjunction with continuous amblyopia therapy. Both patients with moderate amblyopia associated with infantile esotropia and those with partially accommodative esotropia may benefit from a longer duration of amblyopia therapy preoperatively. Conclusions: Patients with strabismic amblyopia need to be followed closely preand postoperatively. Recent research has suggested that for most patients with strabismic amblyopia, therapy should begin at once, followed closely by surgery, and continued amblyopia therapy postoperatively if needed. Though parents may feel more relaxed about their child’s condition, good education by the orthoptist and pediatric ophthalmologist should help to encourage the parents to continue to work toward their child’s best visual outcome.