Binocular fixation pattern and visual acuity in children with strabismic amblyopia

Background: A prospective study was undertaken to compare the binocular fix ation pattern and presence of amblyopia in strabismic children. Methods: Fifty-three children with manifest strabismus and the ability to c ooperate with an optotype acuity test were examined. The binocular fixation pattern and logMAR visual acuity were recorded by separate, masked observe rs under standardized conditions. The binocular fixation pattern was divide d 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 ambly opia in the nonpreferred eye. Conclusion: The binocular fixation pattern can be rapidly assessed with min imal equipment and training. These findings confirm the usefulness of a gra ded assessment of the binocular fixation pattern in the detection of amblyo pia.