Defining and measuring population-level amblyopia treatment outcomes: a proposal by the AAPOS Vision Screening and Research Committees

Abstract

Ophthalmic professional organizations such as the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) strive to support the optimal detection, prevention, and treatment of amblyopia to reduce the community burden of vision loss. To support population-level monitoring with regard to outcomes of childhood amblyopia screening and treatment, the AAPOS Vision Screening and the Research committees propose a set of guidelines for assessing population prevalence of persistent vision impairment due to amblyopia. The committees defined "residual amblyopia" as persistent vision impairment with best-corrected visual acuity worse than logMAR 0.3 (20/40) in one eye with an interocular difference, or visual acuity worse than logMAR 0.3 in both eyes, attributable to unilateral or bilateral amblyopia respectively, with visual acuity deficits not due to other organic causes. Epidemiological assessment of residual amblyopia should be made at an age when amblyopia should have already been detected and treated (8 years). A standardized assessment of residual amblyopia has the potential to promote public health interventions, including quality-improvement projects, for amblyopia screening and subsequent treatment.