Protocolo clínico de manejo da ambliopia baseado em revisão sistemática da literatura

Abstract

Amblyopia is one of the leading causes of low vision in the pediatric age group and represents a preventable public health problem when diagnosed early and treated effectively (AAO, 2023). The present study aimed to develop a clinical protocol based on a systematic review and scientific evidence for the management of amblyopia, whether refractive, strabismic, mixed, or deprivation-related. To this end, a review of the scientific literature was conducted, including classical studies and national and international reference guidelines, such as those from the American Academy of Ophthalmology (AAO) and the Pediatric Eye Disease Investigator Group (PEDIG). The main findings indicate that full initial optical correction alone can promote meaningful improvements in visual acuity in the amblyopic eye (PEDIG, 2003). When the response to optical correction alone is insufficient, the association of complementary therapies is recommended, such as part-time occlusion therapy or pharmacological penalization with atropine (PEDIG, 2004; AAO, 2023). PEDIG studies further demonstrate that two hours of daily occlusion, combined with near visual activities, are effective in improving visual acuity in cases of moderate amblyopia (PEDIG, 2003). Thus, the protocol proposed in this residency completion work aims to organize and consolidate these recommendations into a practical and systematic format. Accordingly, the goal is to standardize clinical management, facilitate early diagnosis, provide practical tools, increase treatment effectiveness, and optimize therapeutic outcomes in pediatric ophthalmologic practice.