LAUSR

PURPOSE To describe amblyopia prevalenceandoutcomes using results from randomized studies anda clinical registry DESIGN: Review of published studies, analysis ofdata in Intelligent Research in Sight (IRIS) Registry from 2013 to 2019, personal perspective; METHODS: Literature review, analysis of IRIS Registry dataand IRIS-50, a visual acuityquality measure RESULTS: Clinical trials have reduced the treatment burden of amblyopia by reducing hours of patching and frequency of atropine eye dropswith clinical success of about 83%. There is no appreciable age effect if treatment is started before 5 years of age, outcomes are stable to at least 15 years of age, and treatment can be somewhat effective until 12 years of age. IRIS Registry identified 1,760,066 individuals with amblyopia for aprevalence of 2.47%. Refractive error alone accounted for 68.9% of childhood cases. Mean amblyopic eye visual acuity improved 1.8 lines for children 3 to 6 years of age and 0.8 lines for 7 to 12 years, but mean residual amblyopia was more than two lines. Among 18,841 children 3 to 7 years of age eligible for IRIS-50, 77.3% were successful. The odds ratiosfor success were significantly lower for African American (0.67; 95% confidence interval = 0.58 to 0.78)and Hispanic or Latino (0.84; 95%CI = 0.75 to 0.94)children compared with whites. CONCLUSIONS Clinical trials provided evidence of a beneficialeffect from several treatments,with substantially reduced doses. Registry data from clinical practicefound residual visual acuity impairment among all ages and races,especially among minorities.