Prevalence and Severity of Amblyopia in Children Under 10 Years with Strabismus: A Cross-Sectional Study at Nishtar Hospital, Multan

Abstract

Background: Amblyopia is a leading cause of preventable childhood visual impairment, often associated with strabismus. Early identification and intervention are critical to optimizing visual outcomes, yet there is limited regional data guiding targeted screening and management. Objective: To determine the prevalence and severity of amblyopia among children under ten years with strabismus at Nishtar Hospital, Multan, and to evaluate its association with strabismus type and demographic factors. Methods: In this cross-sectional study, 100 children aged 6–10 years with clinically confirmed strabismus were assessed for amblyopia severity using standardized visual acuity and ocular alignment protocols. Strabismus and amblyopia classifications, demographic data, and clinical characteristics were systematically recorded. Statistical analysis included descriptive statistics and chi-square tests to determine associations between amblyopia, strabismus type, and gender. Results: Strabismic amblyopia was identified in 32% of cases, with dense amblyopia being the most prevalent (23%). Unilateral strabismus had a significantly higher association with amblyopia compared to alternating strabismus (22% vs 10%, p = 0.002; OR 2.57, 95% CI 1.38–4.79). Esotropia was more strongly associated with amblyopia than exotropia (p = 0.01). No statistically significant gender or age differences were found. Conclusion: Strabismic amblyopia remains a significant public health concern in this region. Early screening and targeted interventions are essential to reduce dense amblyopia rates and prevent long-term visual disability.