Amblyopia refers to reduced vision in one or both eyes caused by visual deprivation. Normal vision is “imprinted” in the brain in early childhood. If this process is interrupted, amblyopia will occur. That is, even with proper eyeglasses, an eye with amblyopia does not see well. It is often reversible with the appropriate treatment. The term “lazy eye” is often used to describe amblyopia.
Amblyopia results from actual atrophy of the visual pathways in the brain that allow an individual eye to “see.” That is, because of improper stimulation of the involved eye, the portion of the brain serving that eye does not develop properly.Amblyopia affects approximately 2% of all children. There is often a family history of this disorder.
Making the Diagnosis
The Paediatric ophthalmologist performs all of the necessary tests to confirm that your child has amblyopia.
Vision testing is accomplished with the appropriate methods for your child’s age.
An examination with eye drops that dilate the pupils is generally performed. This permits an evaluation of the internal ocular structures and allows a determination as to whether or not there is a need for eyeglasses.
The key to successful treatment of amblyopia, is early detection. See Vision Screening for more information.
If the amblyopia is caused by a strabismus, patching therapy is generally recommended.
If an anisometropic amblyopia is present, the proper eyeglasses are prescribed, possibly in conjunction with patching therapy.
If there is a cataract or other ocular anomaly present, the appropriate surgery may be recommended followed by patching therapy.
Eye Patch Therapy
For achieving the best results in amblyopia therapy, total visual deprivation of the stronger eye is often recommended. For this reason, eye patches that adhere to the skin around the eye are most effective. Strap-on “pirate’s patches” and patches worn over glasses or frosted glasses are less effective and usually not recommended.
Particularly if a child is resistant to patching therapy, atropine eyedrops may be helpful in certain conditions. Atropine is instilled onto the dominant eye creating a temporary blurring effect which may allow the child to use the other eye with amblyopia – thus “patching without a patch.”
The Paediatric Ophthalmologist will prescribe the appropriate number of hours that the patch should be worn each day. While undergoing patching or atropine eyedrop therapy, it is critical that your child return for a vision check at the recommended time intervals! This is to safeguard against the development of amblyopia in the eye being patched.
Generally, the younger the child, the quicker the desired results are obtained with amblyopia therapy. After about age eight-nine years, the benefit of patching or atropine therapy is questionable.
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