Amblyopia and Routine Eye Exam in Children: Parent's Perspective

Knowledge and Awareness Regarding Amblyopia Among Parents in Riyadh, Saudi Arabia: A Cross-Sectional Study

Introduction Amblyopia is an abnormal development of usually one eye, leading to permanent decreased vision in the affected eye if not treated early. The condition is primarily caused by strabismus, cataract, anisometropic refractive error, or genetic factors and can manifest from birth to seven years of age, with a worldwide prevalence of 1.75%. This study examines parental knowledge of amblyopia in an effort to improve its early detection and intervention. Improving awareness can have a direct impact by lowering the incidence of untreated amblyopia and its related visual impairment. This study can also help healthcare professionals understand how to communicate with parents about amblyopia more effectively. Materials and methods This cross-sectional study included 417 parent participants from Riyadh, Saudi Arabia, selected through random sampling while ensuring representation from various governorates. The data was collected using an online questionnaire distributed by different social media platforms (Twitter, WhatsApp, and Telegram) to the parents of all governorates, and the sample was selected randomly. It was meticulously cleaned using Excel and analyzed with IBM Statistical Package for the Social Sciences (SPSS) version 29 (IBM Corp., Armonk, NY). Results Our results showed a predominant understanding of amblyopia as "poor vision in one or both eyes" (19.1%) as well as the role of eye movement or brain-eye coordination in the condition. Only 51.3% of parents were aware of lazy eye. Notably, the internet and doctors were the primary sources of information about amblyopia. Only 8.9% of the participants were aware that amblyopia cannot be treated after 10 years of age. Understanding the causes of amblyopia mainly included genetic factors and refractive errors. Sociodemographic factors such as gender, educational level, family history of eye disease, and having a child with a lazy eye significantly influenced the parents' awareness levels of amblyopia. Conclusion Our study underscores the need for targeted educational initiatives to improve the knowledge and awareness of amblyopia among parents in Riyadh, Saudi Arabia. By addressing misconceptions, enhancing access to accurate information, and fostering a deeper understanding of amblyopia and its management, we can work toward ensuring timely diagnosis and appropriate interventions, ultimately reducing the prevalence and impact of amblyopia in the community.

Parents' Awareness, Knowledge, and Perception of Amblyopia in Children: A Study in Jazan Region, Saudi Arabia

Background Amblyopia is a vision disorder that results from a development problem in the brain rather than a neurological disease in the eye. The condition causes reduced visual acuity in one or both eyes due to the brain's inability to process inputs, rather than a structural abnormality. This study aims to assess parents' awareness, knowledge, and perception of amblyopia in their children in the Jazan region, Saudi Arabia. Methods This is a cross-sectional study that used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents in the Jazan region. The Statistical Package for Social Sciences (SPSS v.25, IBM Corp., Armonk, NY, USA) was utilized to input the data. The degree to which participants' level of awareness was related to variables such as age, gender, and educational level was assessed through the chi-square test (χ2), and any values that scored p-values under 0.05 were deemed statistically significant. Results The analysis included 572 participants, 395 mothers (69.0%) and 177 fathers (31.0%). The age groups of the participants were divided into 36-45 years (38.0%), 26-35 years (36.0%), and above 46 years (17.0%). Out of the total, 36 participants (6.0%) had a history of amblyopia, and 73 (13.0%) had a child who suffered from amblyopia. The findings showed that only 18 participants (3.1%) had a good awareness of amblyopia, while 242 (42.3%) had a fair level of awareness. Most participants, 312 (54.5%), were classified as having a poor awareness level of amblyopia. Parents with postgraduate degrees, those with prior awareness, and parents whose children had eye diseases demonstrated higher levels of good awareness. However, gender, age, and residency did not have significant associations with awareness levels. Conclusion While parents must be involved in managing amblyopia, our research found that more than half of the parents surveyed had a limited understanding of various aspects of the disease, which can cause permanent damage to their child's vision. Therefore, we recommend implementing health education programs to increase awareness and knowledge about amblyopia in Jazan.

Knowledge, Attitude, and Practice of Parents Regarding Children's Eye Care in Al-Qunfudah Governorate, Saudi Arabia

BACKGROUND

Visual impairment and blindness have a long-term impact on children. Common causes include refractive error, amblyopia, and cataracts, all of which are preventable.

OBJECTIVES

This study aims to evaluate the knowledge, attitude, and practice of parents regarding children's eye care in Al-Qunfudah governorate, Saudi Arabia.

METHODS

A cross-sectional study was carried out on a convenience sample of 403 parents residing in the governorate of Al-Qunfudah. Data were gathered using a validated, self-administered online questionnaire that required participants' consent and ensured data confidentiality. IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States) was used to do the statistical analysis of the data.

RESULTS

This study included 403 participants; 41.2% of them were 36-45 years old, 75.9% were female, and 88.8% were married. Most of the participants had had their children undergo eye examinations (65%). A positive attitude about child eye care among the participants was observed in 48.9% of them, while the level of knowledge about eye care and its regular examinations was poor in 60% of the study sample. A significant positive correlation was detected between participants' attitudes and knowledge scores about the eye care of their children (r = 0.238, p-value = <0.001). Older adults (P = 0.004), those with employment (P = 0.004), and those with a history of children suffering from eye problems (P = 0.018) are associated with a positive attitude, while better knowledge is associated with the parent's age (P = 0.007) and higher education level (P = 0.047).

CONCLUSION

The knowledge and attitude of the parents regarding their children's eye care were suboptimal, and the main reason for conducting eye examinations on their children was the presence of active eye disease and a symptomatic child. Positive attitudes were more prevalent among those aged 36-45 years, employed, and with a higher number of children with eye problems. Those in the age group of 36-45 who had a bachelor's degree were associated with greater knowledge. There is an urgent need to educate parents about routine and recommended eye screening. Family physicians should conduct opportunistic eye screenings for children who attend primary healthcare facilities and provide parents with educational materials about common eye disorders and children's eye care.

Diabetic Retinopathy and Eye Screening: Diabetic Patients Standpoint, Their Practice, and Barriers; A Cross-Sectional Study

Diabetes mellites (DM) is one of the most common systemic disorders in Saudi Arabia and worldwide. Diabetic retinopathy (DR) is a potentially blinding ophthalmic consequence of uncontrolled DM. The early detection of DR leads to an earlier intervention, which might be sight-saving. Our aim in this cross-sectional study is to assess patients' knowledge and practices regarding DR, and to detect the barriers for eye screening and receiving a check-up from an ophthalmologist. The study included 386 diabetic patients. One hundred and thirty-one patients (33.9%) had T1DM and 188 (48.7%) had T2DM. Most of the diabetic patients (73.3%) know that they must have an eye check-up regardless of their blood sugar level. DM was agreed to affect the retina in 80.3% of the patients, 56% of patients agree that DM complications are always symptomatic, and 84.5% know that DM could affect their eyes. The fact that blindness is a complication of diabetic retinopathy was known by 65% of the diabetic patients. A better knowledge was detected among patients older than 50 years of age (54.9%) compared to those aged less than 35 years (40.9%), which was statistically significant (p = 0.030). Additionally, 61.2% of diabetic patients who were university graduates had a significantly better knowledge in comparison to 33.3% of illiterate patients (p = 0.006). Considering the barriers to not getting one's eyes screened earlier, a lack of knowledge was reported by 38.3% of the patients, followed by lack of access to eye care (24.4%). In conclusion, there is a remarkable increase in the awareness of DR among the Saudi population. This awareness might lead to an earlier detection and management of DR.

Clinical Practice and the Attitude of Ophthalmologists Regarding Amblyopia in the Population of Jordan: A Cross-Sectional Study

Aim The study was aimed at finding out the knowledge and attitude among ophthalmologists regarding amblyopia in the population of Jordan. Methodology This was an observational cross-sectional study conducted in 2021 among ophthalmologists who live and work in the local society of Jordan and were aged between 30 and 50 years. The survey was conducted using an online questionnaire administered through email and various social media platforms. The level of knowledge and awareness of amblyopia, its causes, methods of treatment, and the best age for treating amblyopia was assessed. Results Out of 200 participants, the majority were in the age group of 30-34 years (47.5%). The male:female ratio was 1:1. The average better age for examination and treatment of amblyopia was three to five years (46%). The most common cause of amblyopia was strabismic amblyopia (50%). Children's and parents' cooperation most significantly influenced the treatment's success (49%). The preferred assessment was cycloplegic refraction (56%), and the preferred patching treatment was a direct cover placed over the eye (77%). The average time to treat amblyopia was less than three years in the majority (53.5%). The most critical factor determining the success of treatment was when the treatment began (57.5%). Conclusions Our study found that although the majority of the participants were less experienced overall, they had a good knowledge of the amblyopia age group and the method of examination. Still, there was a mixed response regarding the treatment. Hence there is a need to increase awareness regarding amblyopia by Jordanian ophthalmologists, social organizations, and educational institutes.

The Clinical Characteristics of Amblyopia in Children Under 17 Years of Age in Qassim Region, Saudi Arabia

Purpose

To provide the clinical characteristics of amblyopia in children under 17 years of age in Qassim Region, Saudi Arabia.

Patients and Methods

The study was a cross-sectional hospital-based, included 121 children with amblyopia aged between 3 and 17 years, referred from 6 hospitals in Qassim region to the paediatric optometry clinic at Qassim University medical city. Demographics and comprehensive ocular examination including visual acuity (VA), assessment of anterior and posterior segment, cycloplegic refraction (RE), angle of deviation, and cause of amblyopia were collected.

Results

The mean age at diagnosis of amblyopia was 8.93 ± 3.67 years. The leading cause of amblyopia was strabismus and anisometropia shared the same percentage at 29.75%, and the combined-mechanism at 18.18%. Amblyopia was more common in males 57.85%, particularly strabismic amblyopia in 66.67% and anisometropic amblyopia in 61.11%, p = 0.408. Amblyopia was more predominant in the age group 6- to 9-year-old, particularly, strabismic amblyopia 44.44%, and amblyopia due to a combined mechanism of 36.36%, p = 0.066. The degree of hyperopia was not varied by the cause of amblyopia (P = 0.401), with slightly high hyperopia found in ametropic and strabismic amblyopia. Conversely, hyperopic astigmatism was significantly associated with amblyopia P = 0.020, with a high degree of hyperopic astigmatism found in meridional amblyopia and ametropic amblyopia.

Conclusion

The commonest types of amblyopia in children were attributed to strabismus and anisometropia. Causes of amblyopia differed by age group with strabismus, anisometropia, and combined mechanism accounting for most children aged 6- to 9-years and strabismus for children aged less than 6 years. Hyperopic and myopic astigmatism were significantly associated with anisometropia and meridional amblyopia. Therefore, efforts should be made for early diagnosis and management of childhood amblyopia and uncorrected refractive errors to avoid their impact on quality of life.

Treatment Outcome of Occlusion for Unilateral Amblyopia in Saudi Children 6-12 Years Old

PURPOSE

The purpose of this study was to estimate the rate and review determinants of successful therapy for unilateral amblyopia in children.

METHODS

This prospective cohort consisted of Saudi children aged 6-12 who received amblyopia therapy between 2020 and 2022. Best-corrected visual acuity (BCVA) in the amblyopic eye improved to reach the BCVA of the fellow eye at follow-up visits, or BCVA in the amblyopic eye improved and remained stable over three follow-up visits. Demographic and ocular characteristics were associated with the outcome.

RESULTS

In 30 children, the median BCVA at presentation and the last follow-up was 0.8 logMAR (interquartile range [IQR]: 0.6; 1.0) and 0.45 logMAR (IQR: 0.3; 0.6), respectively. The success rate of amblyopia therapy was 80% (95% confidence interval: 65.7; 94.3). It was 100%, 76.5%, and 77.8% in eyes with anisometropic, strabismic, and mixed types of amblyopia, respectively. Amblyopia grade (P = 0.177), type of amblyopia (P = 0.96), and spectacles as therapy in the past (P = 0.09) were not significantly associated with the successful out. The duration of follow-up was significantly longer in those with unsuccessful outcomes (P = 0.05). Excellent compliance for occlusion was observed in 62.5% of children with successful outcomes. In 14 (46.7%) children, BCVA was ≤0.3 logMAR BCVA at the last follow-up. Two-line improvement in amblyopic eyes was in 26 (86.7%) children at the last follow-up compared to BCVA at presentation.

CONCLUSION

Occlusion therapy complemented using glasses in older children also significantly improved visual recovery in amblyopic eyes.