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Colobomas and Amblyopia

Philip Lempert, MD
[+] Author Affiliations

Author Affiliation: Arleo Eye Associates, Ithaca, New York.


Arch Ophthalmol. 2011;129(11):1505-1506. doi:10.1001/archophthalmol.2011.324
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In their recent report on colobomas, Nakamura et al state that 33% of their subjects had amblyopia and that amblyopia management is the recommended treatment.1 Definitions of amblyopia are consistent in requiring that the visual defect is not caused by anatomic defects. The Pediatric Eye Disease Investigator Group definition is unambiguous: “Amblyopia is reduced best corrected visual acuity in one or both eyes caused by abnormal visual experience during visual development.”2 (p143) Other authoritative definitions confirm this basic concept: “Amblyopia is a partial or complete loss of eyesight that is not caused by abnormalities in the eye.”3 “The term amblyopia, is generally used in a restricted sense to denote reduced vision in an eye in the absence of any ophthalmoscopically detectable retinal anomaly or any disorder in the afferent visual pathways which might cause the defect.”4 Amblyopia is defined as “a decrease of visual acuity in one or both eyes that on physical examination appear normal.”5 (p1704) “Amblyopia has been defined as the impairment of vision without detectable organic lesions of the eye.”6 (p1)

Scientific communications depend critically on consistent, accurate, and proper use of nomenclature. The diagnosis of amblyopia requires eliminating other causes for impairment of vision.4 Conflating limited visual function due to colobomas with amblyopia, as in this report, invites a muddle and disarray of clinical interactions.

AUTHOR INFORMATION

Correspondence: Dr Lempert, Arleo Eye Associates, 100 Uptown Rd, Ithaca, NY 14850 (eyechartplus@aol.com).

Financial Disclosure: None reported.

REFERENCES

Nakamura KM, Diehl NN, Mohney BG. Incidence, ocular findings, and systemic associations of ocular coloboma: a population-based study.  Arch Ophthalmol. 2011;129(1):69-74
PubMedCrossRef
Repka MX, Kraker RT, Tamkins SM, Suh DW, Sala NA, Beck RW.Pediatric Eye Disease Investigator Group.  Retinal nerve fiber layer thickness in amblyopic eyes.  Am J Ophthalmol. 2009;148(1):143-147
PubMedCrossRef
Hubel DH. Eye, Brain, and Vision2nd ed. New York, NY: W. H. Freeman; 1995:193. Scientific American Library Series 22
Duke Elder S, Abrams D. System of Ophthalmology. Vol 6. St Louis, MO: The CV Mosby Co; 1970:294
von Noorden GK. Amblyopia: a multidisciplinary approach. Proctor lecture.  Invest Ophthalmol Vis Sci. 1985;26(12):1704-1716
PubMed
Mazow ML, Chuang A, Vital MC, Prager T. 1999 Costenbader Lecture: outcome study in amblyopia: treatment and practice pattern variations.  J AAPOS. 2000;4(1):1-9
PubMedCrossRef

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Nakamura KM, Diehl NN, Mohney BG. Incidence, ocular findings, and systemic associations of ocular coloboma: a population-based study.  Arch Ophthalmol. 2011;129(1):69-74
PubMedCrossRef
Repka MX, Kraker RT, Tamkins SM, Suh DW, Sala NA, Beck RW.Pediatric Eye Disease Investigator Group.  Retinal nerve fiber layer thickness in amblyopic eyes.  Am J Ophthalmol. 2009;148(1):143-147
PubMedCrossRef
Hubel DH. Eye, Brain, and Vision2nd ed. New York, NY: W. H. Freeman; 1995:193. Scientific American Library Series 22
Duke Elder S, Abrams D. System of Ophthalmology. Vol 6. St Louis, MO: The CV Mosby Co; 1970:294
von Noorden GK. Amblyopia: a multidisciplinary approach. Proctor lecture.  Invest Ophthalmol Vis Sci. 1985;26(12):1704-1716
PubMed
Mazow ML, Chuang A, Vital MC, Prager T. 1999 Costenbader Lecture: outcome study in amblyopia: treatment and practice pattern variations.  J AAPOS. 2000;4(1):1-9
PubMedCrossRef

Correspondence

November 1, 2011
Brian G. Mohney, MD; Kelly M. Nakamura, BS
Arch Ophthalmol. 2011;129(11):1505-1506. doi:10.1001/archophthalmol.2011.325.
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