Hopp til hovedinnhold

Amblyopi

Sist revidert:
Sist revidert av:


Definisjon:
Nedsatt synsskarphet som følge av unormal synsutvikling i spedbarnsalderen og tidlig småbarnsalder
Forekomst:
Prevalens estimeres til å være 1-4%
Symptomer:
Barnet kan ha vansker med å se, skjeler, at øynene vandrer (nystagmus) eller hodet holdes på skakke for å se
Funn:
Det påvises ensidig nedsatt syn, ev. at barnet skjeler
Diagnostikk:
Visusundersøkelse er avgjørende for diagnosen
Behandling:
Tildekking av det friske øyet med lapp, ev. bruk av atropindråper
  1. McConaghy JR, McGuirk R. Amblyopia: Detection and Treatment. Am Fam Physician. 2019 Dec 15;100(12):745-750. PubMed  
  2. Bradfield YS. Identification and treatment of amblyopia. Am Fam Physician 2013; 87: 348-52. American Family Physician  
  3. Holmes JM, Lazar EL, Melia BM, et al.; Pediatric Eye Disease Investigator Group. Effect of age on response to amblyopia treatment in children. Arch Ophthalmol 2011;129(11):1451-7. PubMed  
  4. National Eye Institute. Amblyopia. Accessed 05.06.2019. www.nei.nih.gov  
  5. Williams C, Northstone K, Howard M, et al. Prevalence and risk factors for common vision problems in children: data from the ALSPAC study. Br J Ophthalmol 2008; 92: 959. pmid:18480306 PubMed  
  6. Pai AS, Rose KA, Leone JF, et al. Amblyopia prevalence and risk factors in Australian preschool children. Ophthalmology 2012; 119: 138-44. doi:10.1016/j.ophtha.2011.06.024 DOI  
  7. Holmes JM, Clarke MP. Amblyopia. Lancet 2006; 367: 1343-51. pmid:16631913 PubMed  
  8. Haugen O. Amblyopi. Nasjonal kvalitetshåndbok for oftalmologi. Norsk oftalmologisk forening. Sist faglig oppdatert 31.10.2017. legeforeningen.no  
  9. Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database Syst Rev. 2014;(7):CD006461. Cochrane (DOI)  
  10. Arnold RW, O'Neil JW, Cooper KL, et al. Evaluation of a smartphone photoscreening app to detect refractive amblyopia risk factors in children aged 1–6 years. Clin Ophthalmol. 2018;12:1533–1537. www.ncbi.nlm.nih.gov  
  11. Committee on Practice and Ambulatory Medicine, Section on Ophthalmology. American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Eye examination in infants, children, and young adults by pediatricians. Pediatrics 2003; 111: 902-7. Pediatrics  
  12. Scheiman MM, Hertle RW, Beck RW, Edwards AR, Birch E, Cotter SA, et al., for the Pediatric Eye Disease Investigator Group. Randomized trial of treatment of amblyopia in children aged 7 to 17 years. Arch Ophthalmol 2005; 123: 437-47. PubMed  
  13. Scheiman MM, Hertle RW, Kraker RT, et al.; Pediatric Eye Disease Investigator Group. Patching vs atropine to treat amblyopia in children aged 7 to 12 years: a randomized trial. Arch Ophthalmol 2008;126(12):1634-42. PubMed  
  14. Pediatric Eye Disease Investigator Group. A randomized trial of near versus distance activities while patching for amblyopia in children aged 3 to less than 7 years. Ophthalmology 2008;115(11):2071-8. PubMed  
  15. Matta NS, Singman EL, Silbert DI. Evidenced-based medicine: treatment for amblyopia. Am Orthopt J 2010;60:17-22. PubMed  
  16. Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2002; 120: 268-78. PubMed  
  17. Li T, Shotton K. Conventional occlusion versus pharmacologic penalization for amblyopia. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD006460. DOI: 10.1002/14651858.CD006460.pub2 DOI  
  18. Tailor V, Bossi M, Bunce C, Greenwood JA, Dahlmann-Noor A. Binocular versus standard occlusion or blurring treatment for unilateral amblyopia in children aged three to eight years. Cochrane Database of Systematic Reviews 2015, Issue 8. Art. No.: CD011347. DOI: 10.1002/14651858.CD011347.pub2. DOI  
  19. Repka MX, Wallace DK, Beck RW, et al. Two-year follow-up of a 6-month randomized trial of atropine vs patching for treatment of moderate amblyopia in children. Arch Ophthalmol 2005; 123: 149-57. pmid:15710809 PubMed  
  20. Stewart CE, Wallace MP, Stephens DA, et al. The effect of amblyopia treatment on stereoacuity. J AAPOS 2013; 17: 166-73. pmid:23622448 PubMed  
  21. Hertle RW, Scheiman MM, Beck RW, et al. Stability of visual acuity improvement following discontinuation of amblyopia treatment in children aged 7 to 12 years. Arch Ophthalmol 2007; 125: 655-9. pmid:17502505 PubMed  
  22. Holmes JM, Beck RW, Kraker RT, et al. Risk of amblyopia recurrence after cessation of treatment. J AAPOS 2004; 8: 420-8. pmid:15492733 PubMed  
  23. Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database of Systematic Reviews 2014, Issue 7. Art. No.: CD006461. DOI: 10.1002/14651858.CD006461.pub4 DOI  
  24. Newsham D. A randomised controlled trial of written information: the effect on parental non-concordance with occlusion therapy. Br J Ophthalmol 2002; 86: 787-91. British Journal of Ophthalmology  
  25. Awan M, Proudlock FA, Gottlob I. A randomized controlled trial of unilateral strabismic and mixed amblyopia using occlusion dose monitors to record compliance. Invest Ophthalmol Vis Sci 2005; 46: 1435-9. pmid:15790912 PubMed  
  26. Loudon SE, Fronius M, Looman CW, et al. Predictors and a remedy for noncompliance with amblyopia therapy in children measured with the occlusion dose monitor. Invest Ophthalmol Vis Sci 2006; 47: 4393-400. pmid:17003431 PubMed  
  27. Korah S, Philip S, Jasper S, Antonio-Santos A, Braganza A. Strabismus surgery before versus after completion of amblyopia therapy in children. Cochrane Database of Systematic Reviews 2014, Issue 10. Art. No.: CD009272. DOI: 10.1002/14651858.CD009272.pub2. DOI  
  28. Holmes JM, Melia M, Bradfield YS, Cruz OA, Forbes B; Pediatric Eye Disease Investigator Group. Factors associated with recurrence of amblyopia on cessation of patching. Ophthalmology 2007;114(8):1427-32. PubMed  
  29. McKee SP, Levi DM, Movshon JA. The pattern of visual deficits in amblyopia. J Vis 2003; 3: 380-405. pmid:12875634 PubMed  
  30. Greenwood JA, Tailor VK, Sloper JJ, et al. Visual acuity, crowding, and stereo-vision are linked in children with and without amblyopia. Invest Ophthalmol Vis Sci 2012; 53: 7655-65. doi:10.1167/iovs.12-10313 DOI  
  31. Rahi J, Logan S, Timms C, Russell-Eggitt I, Taylor D. Risk, causes, and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study. Lancet 2002; 360: 597-602. PubMed  
  • Ingard Løge, spesialist allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Olav H Haugen, overlege dr. med., Øyeavdelingen Helse-Bergen, Bergen
  • Knut A. Holtedahl, professor i allmennmedisin, Institutt for samfunnsmedisinske fag, Universitetet i Tromsø