Article Text

Download PDFPDF
Fine visuomotor skills in amblyopia: a systematic review and meta-analysis
  1. Archayeeta Rakshit,
  2. Katrina L Schmid,
  3. Ann L Webber
  1. School of Optometry and Vision Science, Centre for Vision and Eye Research, Faculty of Health, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, Brisbane, Queensland, Australia
  1. Correspondence to Archayeeta Rakshit, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane 4059, Queensland, Australia; archayeeta.rakshit{at}


Background Amblyopia is characterised by reduced visual acuity, poor binocular sensory fusion, and impaired or absent stereoacuity. Understanding the extent to which amblyopia affects everyday task performance is important to quantifying the disease burden of amblyopia and can assist clinicians to understand patients’ likely functional capability.

Methods A systematic literature search identified published studies comparing fine visuomotor performance in either children or adults with amblyopia and those with normal binocular vision. The included studies (22 studies involving 835 amblyopes and 561 controls) reported results of self-perception patient reported outcome measures, tests of motor proficiency and video recorded reaching and grasping. The outcomes of 17 studies were grouped into four meta-analyses, with pooled results reported as standardised mean difference (SMD) with corresponding 95% CI.

Results Regardless of the cause of amblyopia (anisometropia, strabismus, mixed, deprivation), significant reduction in self-perception of physical competence and athletic competence (SMD=−0.74, 95% CI −1.23 to −0.25, p=0.003); fine motor skills scores (SMD=−0.86, 95% CI −1.27 to −0.45, p<0.0001); speed of visually guided reaching and grasping movements (SMD=0.86, 95% CI 0.65 to 1.08, p<0.00001); and precision of temporal eye-hand coordination (SMD=0.75, 95% CI 0.26 to 1.25, p=0.003) occurred in amblyopes compared with those with normal visual development.

Conclusion Reports of the impact of amblyopia on fine motor skills performance find poorer outcomes in participants with amblyopia compared with those with normal vision development. Consistency in the outcome measure used to assess the functional impact of amblyopia would be valuable for future studies.

  • Vision

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text


  • Contributors AR: Conceptualisation, data curation, formal analysis, investigation, methodology, validation, visualisation, writing—original draft preparation, writing—reviewing and editing. KLS: Conceptualisation, methodology, supervision, validation, writing—reviewing and editing. ALW: Conceptualisation, data curation, methodology, supervision, validation, writing—reviewing and editing. The corresponding author, AR: accepts full responsibility of the work and/or the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.