National consensus statement regarding pediatric eye examination, refraction, and amblyopia management

Abstract

Childhood blindness causes significant social and economic burden. Even though pediatric eye care has gained priority under Vision 2020, it continues to come under the purview of tertiary care centers due to lack of knowhow and facilities at primary and secondary level. Currently, India does not have standard guidelines on pediatric eye examination, refraction, and amblyopia management and therefore these are being managed inadequately or inappropriately. In view of this, an expert group of pediatric ophthalmologists from across the country met under the aegis of All India Ophthalmological Society, and deliberated to reach a consensus on the correct method of pediatric eye examination, treating refractive error in children and managing amblyopia. The purpose of the consensus statement was to enable all ophthalmologists to have a broad set of guidelines, which can form the basic framework for managing common pediatric eye conditions, in most ophthalmic setups. The consensus statement is divided into three broad categories: Pediatric eye examination, pediatric refraction, and amblyopia management. The pediatric eye exam subsection discusses the recommended clinical history, which should be taken and the essential components of an ophthalmic examination including pediatric vision assessment. Additionally, it discusses the role of special tests and investigations such as imaging and electrophysiology. The section on pediatric refraction emphasizes the correct use of cycloplegia and prescribing glasses in the Indian context. The final section on amblyopia management presents the various options of treating amblyopia and provides standard guidelines for the use of occlusion therapy and its weaning over time.