Received: 13 June 2018; Published on-line: 31 August 2018

Pre-treatment and post-treatment visual functions in congenital myopia alone versus congenital myopia complicated by amblyopia

A.Iu. Mukhina1, Post-grad Student, I.M. Boichuk2, Dr Sc (Med), L.D. Zhuravliova1, MD

1 Regional Pediatric Clinical Hospital; Ivano-Frankivsk (Ukraine)

2 Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine; Odessa (Ukraine)

E-mail: iryna.ods@gmail.com             


Background: Congenital myopia is a particular form of refractive error which develops prenatally. The reported incidence of myopia in newborns has varied widely, ranging from 6–15% to 25–50%. In the vast majority of cases, myopia in newborns is a transient refractive myopia due to an increased refractive power of the lens, low effect of cycloplegics on the immature ciliary muscle, and some mismatch between some anatomical and optical parameters of refraction. In congenital myopia, there are the blurred out-of-focus images of fixated objects on the foveal and macular regions of the retina, which disrupts normal development both of visual acuity and all central vision functions and structures. Congenital myopia is often associated with amblyopia, which requires specific and durable treatment options. Therefore, timely diagnosis is required to differentiate between the two conditions.

Purpose: To compare visual function parameters before and after pleoptic and orthoptic treatment in congenital myopia alone without versus congenital myopia complicated by amblyopia.

Materials and Methods: Eighteen children (36 eyes; Group 1) with congenital myopia alone and 11 children (20 eyes; Group 2) with congenital myopia complicated by amblyopia, aged 5 to 12 years underwent an eye examination before and after treatment. Contrast sensitivity was measured using the advanced Bausch & Lomb charts (2013), and color thresholds were measured using the charts we have developed previously (Patent of Ukraine for the Utility Model №114,858 issued 01.2017, “Method for measuring color thresholds in young children”). Treatments used included appropriate optical correction of the refractive error, training of accommodation, pleoptic treatment (illumination of the macula with or without the use of color filters; phosphene stimulation; magnetic stimulation using ATOS apparatus; laser stimulation using LAST and RADUGA apparatuses); computer-assisted treatment; light and color stimulation  using ASO and Rucheiok apparatuses; CAM stimulation; and physical therapy (electrophoresis using Aloe vera extract with ascorbic acid; massage of the cervical spine).

Results: After treatment, mean visual acuity improved significantly from 0.87±0.15 to 0.9±0.1 in Group 1, and from 0.19±0.15 to 0.37±0.3 in Group 2 (p < 0.05). In addition, Lang II random-dot test and Titmus stereo fly test demonstrated that the stereovision improved in children with amblyopia (Group 2). Moreover, the time till the occurrence of stereo effect improved from 6.6±3.0 sec to 5.33±3.2 sec in Group 1 (p < 0.05). Furthermore, contrast sensitivity increased from 2.04±0.5 points to 2.22±0.5 points in Group 1, and did not change from baseline (1.1±0.7 points) in Group 2. Improvements in red, yellow, blue and green thresholds in Group 2 were more substantial than those in Group 1, and improvement in yellow threshold in Group 2 (p = 0.03) and those in red and blue thresholds in Group 1 were statistically significant.

Conclusion: Our pleoptic and orthoptic treatment substantially improved visual acuity and improved stereovision both in patients with congenital myopia and in those with congenital myopia complicated by amblyopia. The two groups, however, demonstrated different changes in contrast sensitivity and color perception. The findings indicate that administration of any concomitant therapy for myopia should depend on the presence of amblyopia, and warrant further research on this subject.

Keywords: congenital myopia, amblyopia in the presence of myopic refractive error, visual function parameters, treatment      


  1. Avetisov ES, Mats KA, Shamshinova AM. [Clinical and pathophysiologic characteristics of congenital myopia and possibilities for improving visual function]. Oftalmol Zh. 1988;(7):385-7. Russian
  2. Curtin BJ. The Myopias: Basic science and clinical management. Philadelphia: Harper and Row; 1985.
  3. Grosvenor Т, Goss DA. Clinical management of myopia. Boston: Butterworth-Heinemann; 1999.
  4. Avetisov ES, Kashchenko TP, Shamshinova AM. [Visual functions and their correction in children]. Moscow: Meditsina; 2005.  Russian
  5. Kuzina EI. [Characteristics of congenital myopia]. Oftalmol Zh. 1974;29(3):172-5. Russian
  6. Pil’man NI, Sergeeva PA, et al. [Incapacitating congenital myopia in children]. Oftalmol Zh. 1974;29(3):180-3. Russian
  7. Markosian GA. [Clinical, functional and biological aspects of the pathogenesis, diagnosis and treatment of congenital myopia]. Abstract of Cand Sc (Med) Thesis. Moscow: Helmholtz Research Institute of Eye Diseases; 2017. Russian
  8. Tarutta EP. [Congenital and acquired complicated myopia]. In: Avetisov ES, Kashchenko TP, Shamshinova AM. [Visual functions and their correction in children]. Moscow: Meditsina; 2005. pp. 137-59.   Russian
  9. Sorokina RS, Kivaev AA, Zislina NN. [Contact lenses in rehabilitation of children with congenital myopia]. In: [Proceedings of the 3rd USSR National Conference on Current Issues of Pediatric Ophthalmology]. 23-24 Jan 1989, Suzdal. pp. 257-8. Russian
  10. Starodubtseva EI, Novokhatskii AS. [Clinical classification of congenital myopia].  Oftalmol Zh. 1978;33(1):35-8. Russian
  11. Dvorianchikov AP, Shamshinova AM, Aref'eva IuA. [An analysis of the operation of the retinal on and off channels by the time of the sensorimotor reaction in response to achromatic dot stimuli in the visual field with an angular dimension of 21 degrees]. Zh Vyssh Nerv Deiat Im I P Pavlova. 1997 Nov-Dec; 47(6):1044-6. Russian
  12. Slobodianyk SB. [Curative effect of phosphene stimulation on function of the visual system and ocular and regional cerebral circulation in patients with amblyopia]. Abstract of Cand Sc (Med) Thesis. Odesa: Filatov Institute of Eye Disease; 1999. Ukrainian
  13. Marré M. The investigation of acquired colour deficiencies. In: Marré M, ed. Colour 73. London: Adam Hilger; 1973. pp. 99–135
  14. Reading RW. Binocular vision: foundations and applications. Boston: Butterworth-Heineman, 1983. pp. 76–9.
  15. Boichuk IM. [Pathogenetic mechanisms of amblyopia]. Abstract of Dr Sc (Med) Dissertation. Odesa: Filatov Institute of Eye Disease; 2006. Ukrainian.
  16. Shelepin IuE, Kolesnikova LN, Levkovich IuI. [Visiocontrasometry]. Leningrad: Nauka; 1985.  pp. 54-60. Russian
  17. Hess RF, Howell ER. The threshold contrast sensitivity function in strabismic amblyopia: evidence for a two type classification. Vision Res. 1977;17:1049–55.
    Crossref   Pubmed
  18. Zadnik K, Mannis MJ, Johnson CA, Rich D. Rapid contrast sensitivity assessment in keratoconus. Am J Optom Physiol Opt. 1987 Sep;64(9):693-7.
    Crossref   Pubmed
  19. Bagaeva VI, Chuprov AD, Podyninogina VV, Podyninogin NV. [Electric stimulation of the optic nerve in the comprehensive treatment for amblyopia with refractive error]. In: [Myopia and abnormalities of refraction, accommodation and oculomotor apparatus. Proceedings of the international conference]. 18-20 Dec 2001, Moscow. pp. 168-9. Russian
  20. Barsegian LG, Mkrtchan LG, Metevosian EK, et al. [Our experience of computer-assisted treatment for amblyopia]. In: [Myopia and abnormalities of refraction, accommodation and oculomotor apparatus. Proceedings of the international conference]. 18-20 Dec 2001, Moscow. pp. 169-70. Russian
  21. Kashchenko TP, Mukhamed’iarov F, Shamshinova AM, et al. [Comparing efficacy among computer-assisted treatments for amblyopia]. In: [Myopia and abnormalities of refraction, accommodation and oculomotor apparatus. Proceedings of the international conference]. 18-20 Dec 2001, Moscow. pp. 186-8. Russian
  22. Kolomiiets VA, Brutskaya LA, Pankratova TB. [Comparing efficacy of treatment with patterned illumination fields with black-and-white versus multicolored structure for amblyopia]. Oftalmol Zh. 2001;2:460-96. Russian
  23. Gorbovska IV, Mozga VA. [Evaluation of the treatment effectiveness in obscuration and refractive amblyopia in children]. Vestn Ophthalmol. 1981 Nov-Dec;(6):57-60. Russian
  24. Paramei OV, Sidorenko EI. [Relationship between perinatal pathology and refractogenesis, incidence and type of ocular diseases in children]. Vestn Ophthalmol. 1999;115(6):32–41. Russian
  25. Khvatova AV. [Key activities for eradication of avoidable childhood blindness]. In: [Eradication of avoidable blindness: a global WHO initiative. Proceedings of the Russian Interregional Conference]. 22-23 Apr 2003, Ufa. pp. 53-9. Russian