Binocular fixation pattern and visual acuity in children with strabismic amblyopia

Background: A prospective study was undertaken to compare the binocular fixation pattern and presence of amblyopia in strabismic children. Methods: Fifty-three children with manifest strabismus and the ability to cooperate with an optotype acuity test were examined. The binocular fixation pattern and logMAR visual acuity were recorded by separate, masked observers under standardized conditions. The binocular fixation pattern was divided into four grades from alternation to uniocular fixation. Results: Patients who freely alternated did not have amblyopia, while those who maintained or preferred fixation with a given eye tended to have amblyopia in the nonpreferred eye. Conclusion: The binocular fixation pattern can be rapidly assessed with minimal equipment and training. These findings confirm the usefulness of a graded assessment of the binocular fixation pattern in the detection of amblyopia.