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Test Allows Early Detection of Amblyopia in Infants With Eyelid Haemangiomas PHILADELPHIA -- April 1, 2009 -- In children with vascular birthmarks around the eye, even partial blockage of vision can lead to visual loss due to amblyopia. Now a simple test can detect early evidence of amblyopia in infants too young for conventional vision testing, according to a study in the April issue of the American Journal of Ophthalmology. William V. Good, MD, Smith-Kettlewell Eye Research Institute, San Francisco, California, and colleagues performed the early vision test in 4 infants with vascular haemangiomas on the upper or lower eyelids. None of the 4 infants had had any clinical evidence of amblyopia. The test, called 'sweep visual evoked potential vernier acuity,' works by monitoring brain responses to changes in the alignment of 2 lines. The vernier acuity measurements identified early visual abnormalities in the eyes with birthmarks. Brainwave responses to the shifting lines were significantly reduced in the eyes affected by haemangiomas, compared with the fellow eyes. Vascular birthmarks occurring in the area around the eye have the potential to cause significant vision loss before the abnormality resolves, or before the child is old enough for conventional vision testing. "Many congenital ocular or eyelid abnormalities present physicians with a management conundrum: Is treatment for potential amblyopia necessary?" said Dr. Good. The results showed that vernier visual acuity measurements are a promising tool for early detection of amblyopia-like effects in children with eyelid haemangiomas, who can then be targeted for treatment. "This study has implications for the management of children with intermittent occlusion, who may develop amblyopia even when the clinical assessment is negative," added Dr. Good. "It is likely that these findings extend to other eyelid problems, including congenital ptosis, where amblyopia may be present even in the absence of clinical features for amblyopia." SOURCE: Elsevier E-mail this page to a friend or colleague! To print, use this version