Intact Reading But Impaired Motor Skills During Binocular Viewing in Deprivation Amblyopia
Krista R. Kelly, PhD; Sarah E. Morale, BS; Reed M. Jost, MS; Serena Wang, MD; Eileen E. Birch, PhD `
Retina Foundation of the Southwest
Introduction: Motor deficits and slow reading are present in children with strabismic and/or anisometropic amblyopia during binocular viewing conditions. Two studies have found similar deficits in children with deprivation amblyopia from a dense, visually significant unilateral cataract. However, motor skills were assessed in 4 year olds only, and oral reading was assessed monocularly. Thus, it is unknown how deprivation amblyopia affects these developing abilities under habitual, binocular viewing conditions.
Methods: Reading and motor skills of children treated for unilateral congenital or developmental cataract were compared to age-similar controls under binocular viewing conditions. Children 3-14 years old completed manual dexterity (unimanual, bimanual, drawing trail), and aiming and catching tasks from the Movement Assessment Battery for Children. Children 8-13 years old silently read a grade-appropriate paragraph. Reading rate (words/min) was recorded using the ReadAlyzer®. Amblyopic eye best-corrected visual acuity (BCVA) was obtained.
Results: Motor. Amblyopic children (0.3–1.9 logMAR BCVA) had lower scores compared with controls for drawing trail (amblyopia: n=17, mean±SD=7.5±3.5 vs control: n=41, 9.5±3.3; p=0.045), catching (6.2±2.1 vs 9.6±2.8; p=0.00005), and aiming (7.7±2.1 vs 9.6±2.9; p=0.015). Lower bimanual dexterity (r=-0.52, p=0.032) and catching (r=-0.57, p=0.017) scores were associated with worse BCVA. Reading. Amblyopic children (0.5–1.9 logMAR BCVA) did not differ from controls in reading rate (amblyopia: n=10,189±64 words/min vs controls: n=18, 214±62 words/min; p=0.33).
Discussion: Among children with moderate to severe unilateral deprivation amblyopia, motor skills, but not reading, were affected during binocular viewing. Poorer bimanual dexterity and catching were related to poorer amblyopic eye BCVA.
Conclusion: Motor deficits may hinder academic, athletic, and social success in children with deprivation amblyopia.
References: Birch EE, Cheng C, Vu C, Stager DR. Oral reading after treatment of dense congenital unilateral cataract. J AAPOS 2010; 14(3), 227-31.
Celano M, Hartmann EE, DuBois LG, Drews-Botsch C. Motor skills of children with unilateral visual impairment in the Infant Aphakia Treatment Study. Dev Med Child Neurol 2015;58(2):154-9.