Amblyopia and the pediatrician.

Amblyopia is one of the most common eye ailments in children. Early treatment can frequently eliminate this problem. The responsibility for early recognition falls primarily on the pediatrician. The following summarizes what ought to be done for each age group to rule out amblyopia and its associated condition. Newborn to age four months. Make sure the eyes appear normal externally and have a clear red reflex (no cataracts). Infants after age four months. Check fixation with each eye with a penlight. Check for symmetrical corneal light reflexes. Also check red reflex and fundus. Age two to four years. Be particularly aware of any family history of strabismus or amblyopia. The examination should include an observation of the fixation pattern with each eye, the symmetry of the corneal light reflex, and an evaluation of the fundus and the red reflex. Age four. Visual acuity in each eye should be measured. Ideally, all children should be referred for a complete eye examination and refraction if this is economically feasible. School age. Check vision yearly. If a person is going to have one complete routine eye examination by an ophthalmologist in the first half of his lifetime, checking him at age four would be ideal. It should include a cycloplegic refraction to tule out excessive farsightedness, nearsightedness, astigmatism, or unequal refraction in the two eyes. This should be done by a person thoroughly schooled in recognizing eye diseases rather than by a nonmedical practitioner. Annual eye examinations by an ophthalmologist are probably unnecessary if visual acuity is good and the child is asymptomatic.