AMBLYOPIA
Amblyopia, or “lazy eye,” is a condition in which a child fails to develop normal sight in one or both eyes. Amblyopia may be caused by several different eye and neurological conditions, and can lead to permanent decrease in vision if not treated. Some common causes of amblyopia include eye muscle misalignment, a mechanical blockage of vision, and blurred vision from a focusing problem. Simply stated, amblyopia means that the brain receives a blurred or incomplete image from the affected eye(s), and the visual potential of the affected eye(s) won’t be met unless the problem is remedied.
Amblyopia is best managed by early diagnosis and treatment. When addressed early, there is often little or no decline in vision at the end of treatment. Early treatment provides much better success than late. Previously it was thought that children older than nine years of age were too old to undergo amblyopia treatment, but now it is believed that children as old as fourteen may benefit from amblyopia treatment.
Depending on the form of amblyopia, often caregivers or teachers are the first to recognize the condition. In strabismic amblyopia the child’s eyes are not straight. Deprivation amblyopia is a form of amblyopia in which the eye or surrounding tissues interfere with creation of a clear visual image. Cases of deprivation amblyopia can involve both eyes and can lead to very poor vision if not treated in a timely fashion. Refractive amblyopia is another type of amblyopia in which one eye tends to see much more clearly than the other, and the blurry- sighted eye is ”turned off” by the brain. This type of amblyopia is often only found during vision tests. Refractive amblyopia can affect one or both eyes and is readily treated with glasses.
Vision Screening: The American Academy of Pediatrics and the pediatric ophthalmologists at Eye Consultants of Atlanta strongly recommend vision screening as a means to detect amblyopia. Your pediatrician will perform baseline vision analyses on your child’s eyes, and the earliest of these tests is the detection of a “red reflex.” Identical in nature to the “red eye” that’s seen in flash photographs, the presence of a red reflex allows your doctor to ensure that basic eye structures are intact. Infants are assessed by the ability to fix and follow an object. A toddler’s ability to maintain focus on an object is another helpful test. When children are old enough to consistently identify objects by reading or matching, the eyes are better able to be assessed for amblyopia.
The American Association of Pediatric Ophthalmology and Strabismus (www.aapos.org.) recommends the following guidelines:
Vision Screening Recommendations
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AGE |
TESTS |
REFERRAL CRITERIA COMMENTS |
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Newborn to 6 months |
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6 to 42 months |
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42 months to 5 years |
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5 years and older* |
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* Repeat screening every 1-2 years or after age 5.
Amblyopia Treatment:
Depending on the source of the problem, there are various treatment modalities for amblyopia. The goal of the amblyopia therapy is to provide the brain with a focused and clear image from each eye. Some forms of amblyopia are resolved with surgery, whereas others are treatable with simpler means with the use of glasses or contact lenses. Often your ophthalmologist will recommend patching a “stronger” eye to force the brain to use the “weaker” eye. There are other means to “penalize” the stronger eye in the form of eye drops and glasses that purposely blur the good eye a slight amount. Your pediatric ophthalmologist at Eye Consultants of Atlanta will guide you on the best treatment plan for you and your child.