Amblyopia or lazy eye syndrome is a condition wherein one eye does not have a fully developed sense of sight during childhood. This condition develops in one out of twenty children. This is brought about by the patient not being able to use the impaired eye during childhood. Some cases would affect both eyes and the blurring and loss of the vision cannot be remedied by putting on glasses. This condition can be treated if the patient seeks treatment before the age of seven. If the patient does not, the impairment becomes permanent. Amblyopia is treated by making the patient wear an eye patch to force the impaired eye to see by blocking the use of the normal eye.
Babies who are newly born are able to see and their visual pathway would also continue to grow, building a connection from the eyes to within the brain. Their brains would learn to interpret signals that it receives from the eyes. This developmental pathway would continue on until the child reaches the age of seven or eight. Afterwards, the connection between the eyes and the brain are fully developed and can no longer be changed.
Amblyopia is the result when the child does not properly learn the sense of vision and it can affect just one or two his eyes. This condition can also be treated as a brain developmental problem rather than being an eye complication. In some cases, even after the eye problem has been successfully treated, visual impairment coming from amblyopia becomes permanent unless treated when the patient is below seven years of age.
Comorbidities of Amblyopia
Other eye problems can also cause amblyopia:
- Strabismus or squinting. This is a condition where both eyes are not looking at the same direction, like when one eye looks straight, the other one can be looking upward or downwards. This is because the two eyes do not have the same alignment so their focus is on different directions and points. The brain blocks the signal from one eye to prevent seeing double. Squinting usually occurs during childhood and in some cases, the vision of both eyes remains normal. For people who have cases like this, the focus switches from one eye to another so the visual pathway can develop in both eyes. More cases of squinting would have one dominant eye that focuses on objects while the other eye would be focusing on different points.
- Anisometropia. A refractive mishap such as anisometropia is a result of a difference between the refraction in two eyes. In this condition the brain would ignore signals from the eye with a worse refractive error and this eye would then develop amblyopia. Refractive errors can be corrected by wearing glasses but amblyopia cannot. Other refractive errors would include myopia or being short sighted, hypermetropia or being far sighted and astigmatism.
- Other disorders. Disorders during childhood that can prevent the development of sight can lead to amblyopia. Cataract and corneal injury are examples of this.
Diagnosis for Amblyopia
This condition is diagnosed by testing the patient's vision and examining the eyes. There are different methods to check the vision but it depends largely on the child's age. For children who have squint, they should be carefully monitored because their condition puts them at a higher risk for developing amblyopia.
In UK, the children are given routine eye check-ups during pre-school and school-entry. The reason for this move is to detect and prevent amblyopia while it can still be treatable. But even having routine eye check-ups in school is not enough to ensure that a child has a normal vision. If the parent suspects that his child is having vision problems, then consult a doctor immediately.
A young child or a baby is referred to go to an orthoptist who is trained specialist to assess children with amblyopia and squint. After consulting with an orthoptist, he may also direct the child to consult an ophthalmologist or an eye surgeon next.
Importance of Amblyopia
Once a person is affected with amblyopia, one eye is automatically unable to see properly. The condition for amblyopia can vary from case to case and usually, a patient can see well enough with one eye. But it is always better to see with both eyes because you will be able to see objects in three dimensions and have jobs that would require good vision. If a person develops amblyopia, he is at a higher risk of developing more serious and severe sight problems such as corneal injury or diseases. It is always advised to seek treatment to restore the vision.
Treatment and Correction for Amblyopia
Treatment methods for amblyopia include having the underlying eye complications treated as early as possible such as cataract and refractive problems and making sure to guide the impaired eye to develop vision properly. Always remember that refractive problems can be treated by minor surgery or wearing corrected glasses.
Making the Impaired Eye Work
The patient with amblyopia is asked to wear an eye patch so as to block the vision of the normal eye. This forces the impaired eye to focus and thus learn vision to develop properly. This intervention should be done as early as possible during childhood because it gives very results. Wearing an eye patch could restore the vision up to the normal level.
Wearing an eye patch will vary according to the length of time it should be worn for a day. It also depends largely on the child's age and the severity of the condition. The intervention is continued until the vision is improved or has reached a normal level. This could last for several weeks or months and the child monitored continuously to see if the eye will not develop amblyopia after reaching the age of eight. After the age of eight, the visual pathways going from the eyes to the brain is permanent and further intervention is futile to restore vision.
Aside from wearing eye patches, patients can also wear special corrected glasses or apply eye drops. This intervention also forces the impaired eye to see thus preventing or correcting amblyopia.
There is a therapy called the vision therapy where the patient does visually demanding activities to force the affected eye to see. This therapy is a maintenance treatment to ensure that the eye does not develop a full blown amblyopia.
Prognosis for Amblyopia
The earlier the condition is treated, the more likely the vision can be improved or brought back to a normal level. The younger the child gets treated, the better. Treatment should be done when the child is below seven years old because during this age, the visual pathway can still be manipulated and changed. If the child reaches eight years old, any effort for an intervention will not improve or restore the normal vision of the eye because the visual pathway is already permanent.
The patient should always obey what their doctors tell them to do especially when it comes to their treatment such as wearing an eye patch, a corrected glasses or application of an eye drop. Most of the intervention fails because the children do not follow the directions. Wearing an eye patch is annoying for some children so they tend to take the patch off or discontinue the treatment. Parents and family members should encourage the patient to follow the instructions as directed.
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