Analysis of the potential impact of strabismus with and without amblyopia on visual-perceptual and visual-motor skills evaluated using TVPS-3 and VMI-6 tests

Abstract

Purpose: To investigate the potential impact of strabismus and amblyopia on visual-perceptual skills (VPS) and visual-motor skills (VMS) of patients according to the type of strabismus, visual acuity (VA), state of binocularity, and sex.

Methods: This observational, transverse, prospective study analyzed a sample of 146 children with strabismus (88 male and 58 female) aged 5-15 years from Querétaro, México. To determine the strabismus type, we considered the deviation direction, frequency, binocularity state, and associated and dissociated elements. VPS and VMS were evaluated using the Test of Visual-Perceptual Skills 3rd ed. (TVPS-3) and Visual-Motor Integration Test of Beery 6th ed. (VMI-6).

Results: Sex was the main variable associated with the performance of the analyzed patients on TVPS-3 and VMI-6 (p<0.05); boys obtained better scores than girls in all evaluated aspects. Stereopsis was not a determinant of the patients' performance level but was associated with the far and near angles of deviation in both types of strabismus, esotropia and exotropia. Amblyopia was associated with the spatial relationship (p=0.001) and visual closure abilities (p=0.044). Form constancy skill scores diminished in both types of strabismus (esotropia: p=0.011; exotropia: p=0.004), and VMS were the most affected in patients with strabismus.

Conclusions: The performance of patients with strabismus with and without amblyopia on TVPS-3 and VMI-6 suggests that they adopt a mechanism to compensate for the impact of strabismus on their VPS and VMS.

Keywords: Amblyopia; Cortical changes; Strabismus; Visual-motor abilities; Visual-perceptual skills.