Accommodative Status In Amblyopes And Its Effect On Quality Of Life

PURPOSE: The purpose of this study is to assess accommodative status in amblyopic subjects and its effect on quality of life.METHOD: A cross sectional non randomized study was performed at tertiary eye care hospital. Study was carried out in five stages starting from collection of demographic data, anterior and posterior segment evaluation followed by cycloplegic refraction of selected amblyopes. Lag of accommodation was measured post adaptation, via monocular estimation method (MEM). ASQE questionnaire was filled up by amblyopic subjects or their parents. In the final stage control subjects were evaluated in similar manner, their lag of accommodation was measured and ASQE questionnaire was been filled up by subjects. Statistical analysis was performed using SPSS software.RESULTS: Total of 91 subjects diagnosed with amblyopia wasenrolled in study between 3 to 21 years of age with a mean value of 9.6 ± 4 years. Best corrected Visual acuity in amblyopic eye was in range of 1.77 to 0.30 log unit, while in better or good eye visual acuity was in range of 0.00 to 0.17 Mean value of MEM retinoscopy for amblyopes was found out to be lag of OD :+1.32 ±0.59 D and OS +1.34 ±0.57 D , while that of control subjects was OD: +0.71 ±0.21 D , OS: 0.69±0.24 D.Paired t-test compares lag of accommodation obtainedin amblyopes to that of normal subjects .p value was found to be significant i.e. less than 0.001.For amblyopes R2 value came to be 2.6% while on the other hand R2value for controls was 87%.ASQE scoring for amblyopes was between range of 29 to 49 ,score for near work domain was 9.51 (mean of 1.58) for amblyopes , 6.78 (mean of 1.13)for controls.CONCLUSION: Accommodative response in amblyopic subjects was affected as well as their quality of life as compared to controls. Lag of accommodation directly correlates with the near domain of quality of life score in amblyopes.

Amblyopia And Quality Of Life

Introduction:Quality of Life is an important outcome measure in healthcare.Till today the Quality of Life of Indian amblyopic patient remains poorly understood, as there is no published study discussing them.Method:A prospective cross sectional design of 91 amblyopic subjectsbetween ages3 to 12 years were conducted.Age and gender matched subjectwithout any ocular pathologywere taken as controls.The subjects underwent detailed clinical evaluation. Amblyopia and Strabismus Questionnaire was translated to Gujarati language and psychometric properties were analysed. The subjects completed the validated Gujarati questionnaire.The differences in Quality of Life among amblyopes and controls were examined, according to age, gender andclinical features.Result:Amblyopia and Strabismus Questionnaire had an average content validity index was 0.86. The cronbach’s alpha coefficient for internal consistent reliability was 0.733.The correlation coefficient analysis examining the test retest reliability was 0.914. The mean total score ofAmblyopia and Strabismus Questionnairewas 82.84 +18.44. The mean score for amblyopic subjects were significantly lower (82.84 vs 97.69; p<0.05) than controls.There were no statistical significant differences in the total score and individual domains in respect of age and gender. Amblyopic patients with strabismus scored lower in the scale of social contact and appearance in comparison to the non strabismic amblyopes(p<0.05).Conclusion:The revised Gujarati version of the Amblyopia and Strabismus Questionnaireappears to be a valid and reliable questionnaire in clinical setting for Indian culture for Gujarati population. The amblyopes have a poorer Quality of Life.