Manejo integral de ambliopía severa anisometrópica en paciente pediátrico con miopía magna unilateral en Barranquilla Colombia 2025: reporte de caso clínico

Abstract

Introduction: Severe anisometropic amblyopia secondary to unilateral high myopia in the pediatric population represents an uncommon clinical challenge with complex management, especially in settings where standardized protocols do not exist. Objective: To describe the comprehensive optometric approach and the visual evolution of a pediatric patient with severe anisometropic amblyopia secondary to unilateral high myopia. Case description: An 8-year-old male patient, seen in Barranquilla, Colombia, presented with severe unilateral visual impairment associated with extreme myopic anisometropia. Comprehensive optometric evaluation allowed confirmation of the functional diagnosis of amblyopia and ruled out structural involvement that could explain the visual loss. The personalized management plan included iseikonic optical correction, followed by the use of a soft toric contact lens in the left eye (comfilcon A), occlusion therapy, support with visual training, complementary diagnostic tests, and interdisciplinary follow-up with pediatric ophthalmology and subspecialties such as glaucoma, retina, and vitreous. During follow-up, improvement in visual acuity and in the functionality of the affected eye was observed. Conclusions: The increase in visual acuity in the left eye supports the importance of a comprehensive and individualized approach, as it promotes visual rehabilitation even in cases of severe amblyopia associated with unilateral high myopia; the earlier the intervention, the better the prognosis. This report provides local clinical evidence and highlights the importance of comprehensive optometric management in pediatric patients at high visual risk.