Higher order Aberration : The Second Refractive error in Residual Ametropic and Anisometropic Amblyopia !

C often encounter a situation where residual impairment in vision continue to persist despite adequate and timely treatment (full time, full spectacle correction and/or patching) of children with (ISO) ametropic or anisometropic amblyopia. A repeat evaluation of the optical media, retina and rest of the visual pathway may or may not reveal a previously unrecognised pathology. Not infrequently however, a detailed clinical re-evaluation, electrophysiological tests (ERG, VEP), color vision, perimetry etc. would reveal no abnormality. The clinicians would then wonder about the lack of vision improvement / persistent vision impairment and diagnose the patient with “residual” amblyopia.