Revista Brasileira de Oftalmologia

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Original Article • Rev. bras.oftalmol. 84 • 2025 • https://doi.org/10.37039/1982.8551.20250098 linkcopy

Parental awareness and its role in amblyopia detection and treatment

Conscientização dos pais e seu papel na detecção e tratamento da ambliopia

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective: To evaluate parents’ knowledge and perceptions about amblyopia and its treatment after their child's diagnosis.

Methods: A cross-sectional study included parents of 30 children diagnosed with amblyopia, recruited from a pediatric ophthalmology clinic. Participants completed a questionnaire after the diagnosis of their children, before receiving amblyopia education. The questionnaire assessed parental knowledge, socioeconomic background, and barriers to care. Statistical analyses included descriptive statistics and logistic regression to identify factors associated with awareness and adhesion.

Results: Most parents (85.7%) reported regular pediatric follow-ups, significantly linked to earlier referrals (p < 0.001). Parents initiated 47.6% of consultations due to concerns, while pediatricians prompted 23.8%. Socioeconomic disparities were key barriers, with 61.9% earning 1-2 minimum wages. Transportation issues (38.1%) and scheduling conflicts (33.3%) were significant barriers. Adherence to occlusion therapy was challenging for 66.7%, mainly due to child resistance (47.1%).

Conclusion: Regular pediatric visits support early amblyopia detection. Addressing socioeconomic barriers through school-based vision screening, subsidized transportation, and educational campaigns is essential for improving awareness, diagnosis, and treatment adherence, which could reduce amblyopia's long-term impact.

Keywords:
Amblyopia; Strabismus, Child; Vision screening; Parents; Treatment adherence and compliance

Question	Answer	n (%)	p-value
1. Relationship to the child	Parent	18 (85.7)	Ref.
	Grandparent	3 (14.3)	<0.001
	Other	0	<0.001
2. Family income	Less than 1 minimum wage	6 (28.6)	0.030
	1-2 minimum wages	13 (61.9)	Ref.
	2-5 minimum wages	2 (9.5)	<0.001
	More than 5 minimum wages	0	<0.001
3. Education level	Incomplete basic education	9 (42.9)	Ref.
	Completed basic education	4 (19.0)	0.095
	Completed high school	7 (33.3)	0.525
	Completed higher education	1 (4.8)	0.004
4. What is the child's sex?	Female	9 (42.9)	0.355
	Male	12 (57.1)	Ref.
	Prefer not to disclose	0	<0.001
5. What is the child's age?	1 to 3 years	0	<0.001
	3 to 4 years	5 (23.8)	0.190
	4 to 6 years	9 (42.9)	Ref.
	6 to 7 years	4 (19.0)	0.095
	Older than 8 years	3 (14.3)	0.040
6. Does the child have regular pediatrician follow-ups?	Yes	18 (85.7)	<0.001
6. Does the child have regular pediatrician follow-ups?	No	3 (14.3)	0.001
7. Does the child receive care through private or public health services?	Private sector	0	<0.001
	Public health	18 (100.0)	Ref.
8. What was the age of the child's first ophthalmology appointment?	Up to 6 months	2 (9.5)	0.030
	6 to 12 months	8 (38.1)	Ref.
	12 to 24 months	5 (23.8)	0.317
	2 to 4 years	6 (28.6)	0.513
	4 to 5 years	0	<0.001
	Older than 7 years	0	<0.001
9. Did you know the recommended age for a child's first ophthalmology appointment?	Yes	10 (47.6)	0.758
	No	11 (52.4)	Ref.
10. How did you arrange the child's ophthalmology appointment?	Own initiative	10 (47.6)	Ref.
	Pediatrician's recommendation	5 (23.8)	0.107
	Referral by a public health agent	4 (19.0)	0.050
	Referral by family or friends	0	<0.001
	Other	2 (9.5)	0.006
11. What was the biggest difficulty in scheduling the child's first ophthalmology appointment?	Balancing work schedules	2 (9.5)	0.030
	Scheduling an appointment	7 (33.3)	0.747
	Time availability	3 (14.3)	0.151
	Distance to the clinic	8 (38.1)	Ref.
	Financial constraints (transportation, food)	2 (9.5)	0.008
	Yes	20 (95.2)	Ref.
12. Have you ever noticed a misalignment in the child's eyes?	No	1 (4.8)	<0.001
	Yes	13 (61.9)	Ref.
13. Does anyone in your family have strabismus?	No	8 (38.1)	0.123
13. Does anyone in your family have strabismus?	Up to 4 years	13 (61.9)	Ref.
14. At what age was the child diagnosed with amblyopia?	4 to 7 years	7 (33.3)	0.064
	Older than 7 years	1 (4.8)	<0.001
	Ophthalmologist	20 (95.2)	Ref.
15. Who diagnosed the amblyopia?	Parent	0	<0.001
	School screening	0	<0.001
	Pediatrician	1 (4.8)	<0.001
	Random discovery	0	<0.001
	Up to 2 years	7 (33.3)	0.747
16. At what age did the child's treatment begin?	2 to 4 years	6 (28.6)	0.513
	4 to 7 years	8 (38.1)	Ref.
	Older than 7 years	0	<0.001
	Regular	14 (66.7)	Ref.
17. How regular is the follow-up for the child's treatment?	Irregular (more than 30% missed appointments)	3 (14.3)	<0.001
	No follow-up	2 (9.5)	<0.001
	Google	0	<0.001
18. Where did you receive information about using an eye patch?	Facebook	0	<0.001
	Instagram	0	<0.001
	Medical consultations	21 (100.0)	Ref.
	Books	0	<0.001
	Yes	19 (90.5)	Ref.
19. Did you find the doctor's explanation of the disease satisfactory?	No	2 (9.5)	<0.001
	Yes	14 (66.7)	Ref.
20. Did you face any difficulties using the eye patch at home?	No	3 (14.3)	<0.001
	Skin irritation due to the patch	4 (23.5)	0.151
21. If so, what were the main difficulties?	I did not understand how to use it	0	0.001
	Child refused to use it	8 (47.1)	Ref.
	Other	2 (11.8)	0.024

Parent education level	Diagnosis before age 4 (%)	Adherence to treatment (%)
Incomplete basic education	70	60
High school	50	75
Higher education	30	90

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