EYE CLINIC

AMBLYOPIA-LAZY EYE | EYE CLINIC - EMMETROPIA

What is amblyopia or "lazy" eye

 

Amblyopia or “lazy” eye, as it is more commonly known is the case when one eye of a child sees less than the other without any obvious anatomical or functional problem. As a result, the problematic eye sends an image to the brain that is blurrier than the one sent by the normal eye. When the two images from the eyes are very different from each other, the brain cannot process and merge them into a clear, enhanced and 3D image.

As these two original images are very different from each other, the brain learns to "ignore" (“forget”) the information coming from the eye with the lowest vision to avoid confusion. This causes the eye to become lazy!

Another type of “lazy eye “called strabismus amblyopia is when the weak (or "lazy") eye twists inward or outward (nasal or temporal respectively). Cases that will affect both eyes are rare.

 

In short, amblyopia is characterized as an immaturity of the child's visual system!

 

It is very important to emphasize here that the critical age to diagnose and treat amblyopia or "lazy eye", which is the leading cause of decreased vision in children, is the age of SEVEN (7) YEARS!

Any diagnosis - treatment over the age SEVEN (7) YEARS, CANNOT improve this immaturity of the visual system.

Early diagnosis and treatment can help prevent long-term vision problems in children. The eye with the lowest vision can usually be corrected with glasses or contact lenses or with patching of the "strong" eye. If amblyopia is not diagnosed and treated early, it can lead to permanent vision loss.

 

Symptoms

 

Most of the times the “lazy eye” does not show any obvious pathology,

Symptoms of amblyopia may include:

 

• The eye twists inwards or outwards (nasal or temporal respectively). Eyes that don't seem to work together
• Poor stereoscopic vision (poor field depth perception)
• Squeezing or closing one eye
• The child tilts his head to one side
• Abnormal results in visual acuity tests (usually vision loss)

Sometimes the amblyopic ("lazy") eye is not perceived without an ophthalmological examination as the other normal eye meets our daily needs.

 

Causes

Lazy eye or Amblyopia is therefore an immaturity of the visual maturity of one eye which develops due to abnormal visual development at the beginning of life. This abnormality usually affects the neural pathways between the retina and the brain. When one eye is weaker than the other then it receives fewer visual signals. In this case, the visual stimuli that reach the brain are not appropriate and the visual centers are not trained to see correctly and clearly, so the vision is blurred and over time it cannot mature. Eventually, the ability of the eyes to work together decreases and the brain suppresses or ignores visual information from the weak eye.

Anything that blurs a child's vision or makes their eyes crooked can lead to amblyopia. Common causes of the disease include:

 

• Muscle imbalance (strabismus amblyopia): It is the most common cause of amblyopia and is an imbalance in the muscles that move the eyes. This imbalance can cause the eyes to turn in a certain direction and prevent them from working together
• Difference in visual acuity between the eyes (refractive amblyopia): If there is a large refractive error (e.g. many degrees of myopia, hyperopia or astigmatism) or a significant difference in refraction between the two eyes (anisometropia) it is likely that the weakest eye will present to the clinic with amblyopia. Glasses and / or contact lenses can be used to correct these refractive errors. In some children the amblyopic ("lazy") eye is caused by a combination of strabismus and refractive errors
• Deprivation amblyopia: A problem in the eye - such as a cloudy area in the lens (cataract) - can make it difficult for light to enter the eye, causing the child to see blurry. This loss of visual information can cause amblyopia and in infants requires urgent treatment to prevent permanent vision loss. It is often the most serious type of amblyopia

 

Risk factors

 

Factors associated with an increased risk of amblyopia include:

 

• Premature Childbirth
• Small size at birth
• Family history of amblyopia and heredity
• Developmental problems

 

Diagnosis

 

The ophthalmologist will perform an ophthalmological examination, checking the general health of the eyes, will check for possible strabismus, for differences in vision between the two eyes or for reduced vision in both eyes. He may also use special drops to enlarge the pupils of the eyes (mydriasis), which cause blurred vision that lasts for several hours.

In general, the method used to control vision depends on the age and stage of the child's development:

 

• Infants and toddlers: An illuminated magnifier can be used to detect cataract. Other tests can assess an infant's or young child's ability to focus and follow a moving object
• Children 3 years of age and older: Examinations to assess a child's vision include pictures or letters and each time the eye that is not examined its covered

 

Treatment

 

It is important to start treatment for amblyopia as soon as possible in childhood, when the complex connections between the eye and the brain are formed. The best results are obtained when treatment is started before the age of 6 years.

Treatment options depend on the cause of the amblyopia and how much its vision is affected by this condition. The ophthalmologist may recommend:

 

• Corrective glasses: Glasses can correct problems such as myopia, hyperopia and astigmatism that can lead to amblyopia
• Eye Patching: To stimulate the weak eye, the child wears a patch /cover on the eye with better vision. The treatment is individualized each time but usually the patching can be applied two or more hours a day. In any case, continuous monitoring by an ophthalmologist is necessary to check the effectiveness of the treatment but also to prevent the development of amblyopia in the other eye
• Eye drops: A drop of atropine drops can temporarily blur vision in the strongest eye. It is usually prescribed for use on weekends or every day which forces the child to use the weakest eye as an alternative to the patching. Side effects include photosensitivity and eye irritation
• Surgery: The child may need surgery if they have eye problems such as a cataract that causes deprivation amblyopia. If the child's eyes continue to squint even with the right glasses, the ophthalmologist may recommend squint surgery as an additional treatment for amblyopia

 

Activity-based therapies - such as painting or puzzles - have also been proposed but their effectiveness has not yet been fully established as research on new therapies continues.

In most children with amblyopia, proper treatment improves vision within weeks to months and treatment can last from six months to two-three years.

It is important that your child is monitored for recurrence of amblyopia (it can occur in up to 25% of children under treatment). If amblyopia returns, then treatment should be resumed.

 

Why Emmetropia Eye Clinic

 

The Emmetropia Eye Clinic is the first private refractive center to obtain ISO:9001 quality certification, thus ensuring the continuous quality of our health services. At Emmetropia, we are investing in new technology to ensure that all measurements, examinations, and finally treatments are performed accurately.

Our medical staff will inform you and advise you in detail on the best possible solution.

In our center there is a special section of glasses that in case of amblyopia includes the state-of-the-art electronic frames of Amblyz™ with electronic shutter in order to avoid patching and make it easier for our young patients to receive continuous treatment.

The state-of-the-art technology available at our center also gives us the opportunity to perform refractive and other surgeries that are needed in case of amblyopia.