Primary prevention

When risk factors are identified, perform at least one comprehensive ophthalmic exam. Risk factors include:​[1]​

  • Uveitis

  • Ptosis

  • Gestational age <30 weeks

  • Birth weight <1500 g

  • Delayed visual or neurologic maturation of unclear etiology

  • Cerebral palsy

  • Syndromes with ocular involvement (e.g., Down syndrome)

  • A family history of amblyopia, strabismus, childhood cataract, or childhood glaucoma.

It is also important to correct amblyogenic refractive errors.[1]​​ See Screening.

Amblyopia meets the World Health Organization criteria for a disease that benefits from screening, but the preferred method (e.g., light reflex testing, automated photoscreener, visual acuity testing), screener (e.g., primary care provider, preschool or school, community-based screener), and timing and frequency are subject to debate.[24][25]

Secondary prevention

The American Academy of Ophthalmology recommends that patients who are functionally monocular due to amblyopia should receive help to prevent vision loss to the better-seeing eye by:​​[1]​

  • Wearing polycarbonate spectacles even if they do not require refractive correction

  • Wearing protective goggles and facial protection for contact sports and potentially dangerous activities such as paintball

  • Having regular eye exams throughout life.

Inform patients with any degree of vision loss about vision rehabilitation, because even early vision loss can be associated with disability. Referral should always be considered in patients who report difficulty with visual tasks, difficulty adjusting to vision change, and those with best corrected visual acuity <20/40 in the better eye. Vision rehabilitation should be individualized to each patient and extend beyond optical correction to improve other meaningful outcomes (e.g., reading, daily living activities, safety, community participation, and psychosocial well-being).[96] Although there is insufficient evidence to recommend active interventions (e.g., binocular therapy), these may have a place in some patients.[1]​​[63][73][74][75][76][77]

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