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amblyopia article
 

Amblyopia defined

Amblyopia is also known as lazy eye. It is a condition, usually found in children, in which one or both eyes do not develop properly. An easy way to explain this is that the "eye-brain" connection does not communicate properly; therefore, the child does not know what clear vision is...or what 20/20 vision is. The eye anatomy itself is normal, but the neural pathway to the brain is not normal, causing decreased vision.

Prevalence of amblyopia

Amblyopia is one of the most common treatable forms of vision impairment in children. Its prevalence is as high as 3-5% in some studies. It is most common in infants and young children and it is imperative that this condition is caught early.  The chance of successful vision restoration goes down dramatically after age 8, therefore the earlier this condition is caught the better chance of successful treatment.

Causes of amblyopia

The causes of amblyopia are varied. A very common condition that can cause amblyopia is strabismus, a misalignment of the eyes. This occurs when one eye has an abnormal turning in or out, causing the brain to stop using the misaligned eye. Other causes may come from a high prescription such as nearsightedness, farsightedness, or astigmatism. In the case of these conditions, the eye’s vision is out of focus and so the brain turns off that image. Eye disease processes can also cause amblyopia. One of these conditions is known as a cataract. A cataract is a condition of the lens of the eye developing an opacity so that light cannot pass through. Abnormal retinal conditions and hereditary factors can also cause amblyopia.

Treatment of amblyopia

amblyopia treatmentIn order to increase the chances for success, this condition must be detected early. The recommended ages for early eye examination are 6 months old, then 2-3 years of age, and then school age.

Patching, or occlusion therapy

One of the most common treatments for amblyopia is patching, also known as occluding, the better or stronger eye.  This forces the brain to use the weaker eye.  An adhesive eyepatch on the skin or a slip-on patch over glasses can be incorporated for occlusion therapy. A blurring contact lens or dilating eye drop can also be used to occlude the good eye.

Surgery

Cataract, eye muscle, or retinal surgery can be incorporated to help treat the underlying cause of amblyopia in some cases.

Vision therapy

Vision therapy has been proven to be successful in the treatment of amblyopia. Vision therapy, or VT, incorporates a series of vision training procedures that helps improve eye movement control, visual acuity, depth perception, and eye coordination. Vision therapy can be done in an office or home setting.

Signs and symptoms of Amblyopia

The most common way amblyopia is diagnosed is a detection of a decreased red reflex in the child's eye.  A diagnostic instrument used by the optometrist, ophthalmologist, or pediatrician, can pick up a bright reflection in the normal eye and a dim reflection in the amblyopic eye. Upon further examination, the eye is dilated to see if a refractive error of myopia, astigmatism, or hyperopia is the cause.

Another sign of amblyopia is an eye that turns in or out. A symptom that may be indicative for amblyopia is if the child prefers the vision out of one eye.  This can sometimes be detected when occluding the better eye--the child may become fussy and upset because she cannot see out of the lazy eye.

 Citations:
1. Amblyopia informational patient brochure. APOS.org. January 2013

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What can be expected during a contact lens fitting?

A patient can expect to have a different experience when having a contact lens fitting. In addition to the eyeglass exam, questions will be asked to determine which contact lens will work best for them. Will they want to leave the lenses in their eyes overnight or will they remove them every day? Will they wear them only occasionally or will they be for everyday use? Do they want a contact lens that they throw away every day or do they want a contact lens that they have to clean and disinfect? If the patient is over age 40 and has a compromised ability to see up close, how will they see up close with their contact lenses? Will they wear readers over their distant contacts, or will they wear multifocal contacts, or will they wear monovision?

Are some people more prone to having Dry Eyes than others?

Experiencing dry eye symptoms is more common as we grow older, particularly in people 50 years of age and older. Hormonal changes in women who are experiencing menopause or who are post-menopausal. Inflammation in our body can affect the tear gland's ability to produce tears. Eye or health conditions such as glaucoma, diabetes, lupus, rheumatoid arthritis, and Sjogren's Syndrome can be associated with Dry Eyes. Environmental conditions such as dry winter air, dry indoor heated air, working on the computer, and wearing contact lenses can cause Dry Eyes.

Are there advantages to single-use contact lenses? What are they?

Single-use daily wear contacts are convenient to the patient and a healthy recommendation from their eye doctor. At the end of the day, the patient only has to dispose of the contacts. There is no need to take the contacts out to clean and disinfect them. The patients time and money spent on solutions and caring for them are eliminated. Not to mention that the next time they wear a contact, they will be wearing a brand new contact! The single best recommendation your eye doctor can make is to recommend single-use daily wear contacts. They are the healthiest contact that can be worn. The contact lens pathology issues of wearing the same contact for two or four weeks such as neovascularization, microcystic edema, and bacterial infections are greatly reduced.

What is an eye infection?

Your eyes can get infections from bacteria, fungi, or viruses. Eye infections can occur in different parts of the eye and can affect just one eye or both. Two common eye infections are conjunctivitis (also known as pink eye) and lid styes which are swollen lid bumps that can also be painful. Common signs of an eye infection are pain, itching, or a sensation of a foreign body in the eye, photosensitivity, redness or small red lines in the white of the eye, discharge of yellow pus that may be crusty upon awaking, and tears.

What happens during a typical Diabetic Eye Exam?

Your Eye Doctor will evaluate the back of your eye called the Retina to check for leaking blood vessels. Diabetic retinopathy occurs when elevated blood sugars damage the walls of the blood vessels. The vessel walls may thicken, leak, develop clots, close off, or grow balloon-like defects called microaneurysms.

My eyes tear all the time. Why do you call it Dry Eyes?

Your eyes have extra tears because your eyes produce extra tears to combat irritation and dryness. A better way to describe Dry Eyes is tear film instability, which refers to the composition of your tears not being in the proper composition. Stopping eyes from producing extra tears is a goal in the treatment of Dry Eyes.

At what age should my child have his/her eyes examined?

If you ask 10 different Doctors you will get 10 different answers. Newborns have their eyes checked in the birthing ward for starters. From birth to age 5 their eyes are growing. At age 5 is a good time to schedule a regular eye examination, however, if any unusual eye behavior is observed under age 5 an eye exam should be scheduled at that time. Unusual eye behavior such as eye squinting, a head tilt, or having to get close to see.