Optometry & Visual Performance 174 Volume 14 | Issue 2 | June 2026 Article • A Comparative Cross-sectional Study on Amblyopia and its Relationship with Retinal Nerve Fiber Layer Thickness Muhammad Asad Saeed, BS Optom Azka Sadat, MS HCM, BS Optom Fareeha Ayyub, M Phil Optom Amtul Aziz, DOMS, MBBS Rida Fatima, BS Optom Qurat ul Ain, BS Optom Pakistan Institute of Ophthalmology, Al-Shifa Trust Eye Hospital • Rawalpindi, Pakistan ABSTRACT Background: Amblyopia affects approximately 1.75% of the world’s population. Atrophic alterations in the lateral geniculate nucleus have been observed in amblyopic eyes, leading to the hypothesis that retinal nerve fiber layer (RNFL) thickening is caused by a limitation of normal postnatal ganglionic cell reduction. This study was conducted to determine and compare the thickness of the RNFL in all types of amblyopic and non-amblyopic eyes. Methods: A comparative cross-sectional study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi over six months. Data were collected from 70 patients (140 eyes) using a clinical structured questionnaire. RNFL thickness was measured using optical coherence tomography. All amblyopic patients were included in this study. A one-way ANOVA and paired sample t-test were applied to compare the RNFL thickness between amblyopic and non-amblyopic eyes. Results: The mean age of the patients was 10.20±2.811, ranging from 5 to 16 years. The mean Introduction An estimated 285 million people around the world are visually impaired; nineteen million are children below the age of 14 years. Refractive errors, which are the most common cause of vision impairment in children, affect about 43% of this population.1 In 2020, 16 million in Pakistan suffered distance vision loss, while over 10 million suffered from nearsightedness.2 The prevalence of amblyopia is 1% to 5% globally, while Asians have a 3% prevalence.3 Refractive errors and amblyopia are the most common reasons for visual loss in children.4 Amblyopia, which comes from the Greek phrase “dullness of vision,” is the leading cause of vision loss in infants.5 Amblyopia is a neurodevelopmental and neurophysiological ocular condition that causes poor vision but has no associated pathology. It can be treated most effectively if started at an early stage.6 Muhammad Asad Saeed, BS Optom Rawalpindi, Pakistan Optometrist, Shifa International Hospital Islambad, Pakistan BS Optometry and Orthoptics PIO, ASTEH Rawalpindi, Pakistan, 2022 DHA-ELIGIBLE Optometrist Worked on project “INSPIRE” in collaboration with KEMU Lahore, Pakistan and Sightsavers thickness of RNFL globally in strabismic amblyopia was 108.1±14.1, whereas in anisometropic and bilateral refractive amblyopia, the RNFL thickness was 105.74±11.042 and 107.84±12.329, respectively. There was no statistical mean difference between thicknesses of strabismus, anisometropic, and bilateral amblyopia. There was no statistically significant difference found between the thicknesses among all quadrants of anisometropic amblyopia. Conclusion: There was no significant difference in RNFL thickness between different types of amblyopia. Similarly, there was no significant difference in the thickness of RNFL in amblyopic and non-amblyopic eyes. Keywords: amblyopia, optical coherence tomography, retinal nerve fiber thickness
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