Distribution and Patterns of Refractive Errors in a Pediatric Amblyopic Cohort Aged 3-5 Years: A Descriptive Study in a Pakistani Tertiary Eye Care Center.

PURPOSE: To assess the patterns and severity of different refractive errors in children aged 3 to 5 years presenting with established amblyopia in a tertiary care eye centre in Pakistan.

PATIENTS AND

METHODS

A cross-sectional study was conducted at a tertiary care eye center involving 178 children (aged 3-5 years). The study specifically included only those with refractive amblyopia; children with strabismic or sensory deprivation amblyopia were excluded. From each participant, only the amblyopic eye (or the eye with the worse visual acuity in bilateral cases) was analyzed to ensure statistical independence. All participants underwent a comprehensive ophthalmic examination, including cycloplegic refraction (using 1% cyclopentolate) and dilated fundus evaluation. Refractive errors were classified according to MEPEDS criteria, and data was analyzed using SPSS version 24.0.

RESULTS

Among the 178 amblyopic eyes, astigmatism (53.4%) was common, particularly myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%). Females were more likely to have myopia or astigmatism, whereas males were more likely to have hyperopia or astigmatism which may indicate some gender-specific patterns in amblyopia. Hyperopia was mostly low to moderate, while moderate astigmatism was more common than high astigmatism. These differences were also statistically significant (p < 0.001). Amblyopes with myopic astigmatism (n = 28, 15.7%) and hyperopic astigmatism (n = 27, 15.2%) exhibited the poorest visual acuity (mean LogMAR VA 1.05 ± 0.49 and 0.96 ± 0.46).

CONCLUSION

Astigmatic refractive errors are more likely associated with greater amblyopia severity, and even lower thresholds of refractive error have the potential to cause amblyopia. By establishing these amblyogenic patterns, our study provides the surveillance data essential for early intervention. These findings advocate for preschool screening to prevent irreversible vision loss, directly advancing the WHO SPECS 2030 goal of people-centered eye care.