Treatment of Amblyopia
Wednesday, July 2nd, 2008Treatment for amblyopia begins as soon after diagnosis as possible. Early treatment usually can reverse the condition. Treatment should begin before a child’s vision has fully developed (around age 9 or 10). The younger the child is when treatment begins, the better his or her chances are for developing good vision. Amblyopia can be hard to correct after age 9. But studies suggest that treatment beyond this age can still correct amblyopia. Glasses or contact lenses improve some conditions, such as unequal vision. Other conditions, such as cataracts and some forms of strabismus, may require surgery.
A child born with a cataract or any defect that keeps light out of the eye needs immediate treatment because amblyopia may become permanent within a few months. Amblyopia that results from misaligned eyes (strabismus) or unequal vision in the eyes (anisometropia) usually develops more slowly. Treatment corrects amblyopia by training the brain to use visual signals from the eye with weaker vision, building a stronger connection between the brain and the weak eye, and allowing vision to develop normally in that eye.There are several ways to force the weak eye to get stronger. Methods include wearing an eye patch (also called occlusion) and using eyedrops or glasses (also called penalization). The most common type of penalization treatment uses eyedrops (usually atropine) to blur the vision in the stronger eye and force the brain to use the weaker eye. Eyeglasses with a blurry lens over the stronger eye force the brain to use the weaker eye.
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A misalignment of the eyes (strabismus) is the most common cause of functional amblyopia. The two eyes are looking in two different directions at the same time. The brain is sent two different images and this causes confusion. Images from the misaligned or “crossed” eye are turned off to avoid double vision. In Anisometropia there is a difference of refractive states between the two eyes. Cataract cause the image to be blurrier than the other eye. The brain “prefers” the clearer image. The eye with the cataract may become amblyopic. Ptosis is the drooping of the upper eyelid. If light cannot enter the eye because of the drooping lid, the eye is essentially not being used. This can lead to amblyopia. Nutritional deficiencies or chemical toxicity may result in amblyopia. Alcohol, tobacco, or a deficiency in the B vitamins may result in toxic amblyopia. Amblyopia can run in families.







