Abstract
Abstract: :
Purpose: Little is known about the disadvantages associated with strabismus and/or amblyopia in areas other than visual. This is important when considering treatment options, and also when considering the cost–effectiveness of pre–school vision screening. The aim of this analysis was to assess to what extent the presence of a manifest strabismus and/or amblyopia (defined as an interocular difference in acuities of ≥0.2 LogMar units) was associated with a reduction in motor skills, in a large cohort of healthy children. Methods: As part of a population birth cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), 6858 children at age 7 ½ years had both an orthoptic examination – including LogMar visual acuity, ocular alignment and stereopsis – and an assessment of their motor skills using an adaptation of the Movement Assessment Battery for Children (Movement ABC) – including placing pegs, a test of manual dexterity, and the beanbag game, a test of visuospatial skills at distance. Results: Children with a manifest strabismus (n=158) scored on average less well than children without strabismus in both tests. In the placing pegs test median times to complete the task were 23 vs. 21 seconds (p<0.001) and in the beanbag game the median number of successful throws were 5 vs. 6 (p=0.003). However, the results for children with amblyopia (n=82) and without, excluding those with manifest strabismus, were not significantly different from each other; median times to complete the peg task were 22 vs. 21 seconds (p=0.552), median number of successful throws were 6 vs. 6 (p=0.504) for the beanbag game. Conclusions: These data show that children with strabismus performed less well on both the manual dexterity test and the ball skills test. Amblyopia, however, did not appear to affect either test. This indicates that children with strabismus might need extra help and encouragement from parents and teachers in certain areas. Further investigation is needed to determine whether treatment of strabismus improves motor skills, which could be useful outcomes by which to measure the effectiveness of treatment.
Keywords: strabismus • amblyopia • clinical (human) or epidemiologic studies: natural history