The prevalence of amblyopia in the US is about 2% to 3%.[5]Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months: the multi-ethnic pediatric eye disease study. Ophthalmology. 2008 Jul;115(7):1229-36.e1.
http://www.ncbi.nlm.nih.gov/pubmed/17953989?tool=bestpractice.com
[8]Preslan MW, Novak A. Baltimore Vision Screening Project. Ophthalmology. 1996 Jan;103(1):105-9.
http://www.ncbi.nlm.nih.gov/pubmed/8628540?tool=bestpractice.com
[9]Nilsson J. The negative impact of amblyopia from a population perspective: untreated amblyopia almost doubles the lifetime risk of bilateral visual impairment. Br J Ophthalmol. 2007 Nov;91(11):1417-8.
http://www.ncbi.nlm.nih.gov/pubmed/17947260?tool=bestpractice.com
[10]Robaei D, Kifley A, Rose KA, et al. Impact of amblyopia on vision at age 12 years: findings from a population-based study. Eye. 2008 Apr;22(4):496-502.
http://www.ncbi.nlm.nih.gov/pubmed/17384576?tool=bestpractice.com
Boys and girls are affected equally. A 2019 population-based observational study of amblyopia and refractive error in schoolchildren in Ireland and Northern Ireland found that amblyopia prevalence was significantly lower in Northern Ireland (1%) than in Ireland (4.5%). The prevalence of two key amblyogenic factors, strabismus and anisometropia, did not differ significantly between the two cohorts. However, children living in Ireland, where school-entry vision screening coverage is less comprehensive, free eye care is less accessible, and long waiting times exist, had a higher prevalence of amblyopia, which was associated with socioeconomic disadvantage.[11]Harrington S, Breslin K, O'Dwyer V, et al. Comparison of amblyopia in schoolchildren in Ireland and Northern Ireland: a population-based observational cross-sectional analysis of a treatable childhood visual deficit. BMJ Open. 2019 Aug 10;9(8):e031066.
https://www.doi.org/10.1136/bmjopen-2019-031066
http://www.ncbi.nlm.nih.gov/pubmed/31401612?tool=bestpractice.com
The multiethnic pediatric eye disease study from Los Angeles County showed that the prevalence of amblyopia varies with ethnicity, with a prevalence of 1.5% among African-American children and 2.6% among Hispanic or Latino children.[5]Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months: the multi-ethnic pediatric eye disease study. Ophthalmology. 2008 Jul;115(7):1229-36.e1.
http://www.ncbi.nlm.nih.gov/pubmed/17953989?tool=bestpractice.com
A population study of inner-city Baltimore youth found a prevalence of 3.9%.[8]Preslan MW, Novak A. Baltimore Vision Screening Project. Ophthalmology. 1996 Jan;103(1):105-9.
http://www.ncbi.nlm.nih.gov/pubmed/8628540?tool=bestpractice.com
Most cases of amblyopia in the multiethnic pediatric eye disease study were attributable to refractive error (about 75%).[5]Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months: the multi-ethnic pediatric eye disease study. Ophthalmology. 2008 Jul;115(7):1229-36.e1.
http://www.ncbi.nlm.nih.gov/pubmed/17953989?tool=bestpractice.com
Anisometropic amblyopia is the most common subtype of refractive amblyopia.[6]Attebo K, Mitchell P, Cumming R, et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998 Jan;105(1):154-9.
http://www.ncbi.nlm.nih.gov/pubmed/9442792?tool=bestpractice.com
The next most common cause of amblyopia is strabismus.[6]Attebo K, Mitchell P, Cumming R, et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998 Jan;105(1):154-9.
http://www.ncbi.nlm.nih.gov/pubmed/9442792?tool=bestpractice.com
However, other studies have found strabismus to be a more common subtype of amblyopia than is anisometropia.[7]Shaw DE, Fielder AR, Minshull C, et al. Amblyopia: factors influencing age of presentation. Lancet. 1988 Jul 23;2(8604):207-9.
http://www.ncbi.nlm.nih.gov/pubmed/2899674?tool=bestpractice.com
Such differences may be explained by the populations studied (eye clinic patients versus population-based surveys) and the way in which studies define amblyopia. In addition, strabismus and anisometropia frequently coexist (combined-mechanism amblyopia); thus, classification into one category or another is arbitrary. Form-deprivation amblyopia is least common but tends to be most visually devastating, in part because it often presents in infancy.[6]Attebo K, Mitchell P, Cumming R, et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998 Jan;105(1):154-9.
http://www.ncbi.nlm.nih.gov/pubmed/9442792?tool=bestpractice.com
Amblyopia prevalence does not vary with age.[5]Multi-ethnic Pediatric Eye Disease Study Group. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months: the multi-ethnic pediatric eye disease study. Ophthalmology. 2008 Jul;115(7):1229-36.e1.
http://www.ncbi.nlm.nih.gov/pubmed/17953989?tool=bestpractice.com
However, detection of amblyopia is more challenging in young preverbal children than in older children. Anisometropic amblyopia tends to be diagnosed later than strabismic amblyopia because anisometropic children exhibit signs of a vision problem only when monocular visual acuity is tested.[6]Attebo K, Mitchell P, Cumming R, et al. Prevalence and causes of amblyopia in an adult population. Ophthalmology. 1998 Jan;105(1):154-9.
http://www.ncbi.nlm.nih.gov/pubmed/9442792?tool=bestpractice.com
[7]Shaw DE, Fielder AR, Minshull C, et al. Amblyopia: factors influencing age of presentation. Lancet. 1988 Jul 23;2(8604):207-9.
http://www.ncbi.nlm.nih.gov/pubmed/2899674?tool=bestpractice.com