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Br J Ophthalmol 2006;90:132-133 doi:10.1136/bjo.2005.080689
  • Commentary

How should we manage an amblyopic patient with cataract?

  1. J E Hale1,
  2. S Murjaneh2,
  3. N A Frost3,
  4. R A Harrad1
  1. 1Bristol Eye Hospital, Bristol, UK
  2. 2South Devon Healthcare NHS Trust, Torbay, Devon, UK
  3. 3South Devon Healthcare NHS Trust and Peninsula Medical School, Plymouth, UK
  1. Correspondence to: R A Harrad Bristol Eye Hospital, Lower Maudlin Street, Bristol BS1 2LX, UK; r.a.harrad{at}bristol.ac.uk

    The decision to operate depends on a clear understanding of symptoms, functional impairments, and surgical outcomes in this patient group

    Approximately 3% of the population have a history of amblyopia or strabismus. In all, 300 000 cataract operations are performed each year in the United Kingdom.1 Consequently, about 9000 cataract extractions are performed for amblyopic patients, which equates to the annual cataract workload of two large provincial hospitals. It is not always easy to decide when to operate on cataract in amblyopic patients and with rising patient expectations from cataract surgery we may be confronted with such decisions with increasing frequency. With growing demands on resources there is pressure for these decisions to be made using a good evidence base.

    We performed a literature search on Medline from 1951 and Embase from 1974. There were no publications that specifically addressed amblyopia and cataract surgery. We present a review of the current literature in areas relevant to amblyopia and cataract.

    HOW DO WE JUDGE THE NEED FOR CATARACT SURGERY?

    Much of the visual input from the amblyopic eye is usually suppressed, so it might be expected that cataract in this eye would not significantly affect the patient’s quality of life. However, patients are frequently symptomatic and request cataract surgery on the amblyopic eye. Studies on the effect of cataract on the patient tend to exclude patients …

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