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The treatment of Amblyopia

What is Amblyopia?

Amblyopia, commonly known as lazy eye, is a vision disorder that, if not diagnosed and treated in a timely manner, can severely reduce vision or even render one eye nearly blind. When identified early, amblyopia is easily treatable. Some children may appear healthy but don’t have good vision. The development of the visual system in the brain continues from the fetal stage to around the age of ten, with the maximum growth rate during the first three years of life. During this period, the visual system’s development results in clear and full vision. Any factor that disrupts vision during this period, especially during the first three years, can halt the growth and development of the visual system, causing a decrease in a child’s vision. This means that an eye that appears normal in appearance can still lack normal and complete vision if the child’s vision problems aren’t treated before the age of five, even if the eye has become amblyopic during this time, it can regain normal vision with treatment.

After the age of five, the effect of treatment for amblyopic eyes becomes less effective as time goes on. So, after the age of seven to ten, treatment is unlikely to improve vision. Amblyopia is a reduction in vision that can’t be traced to any apparent organic (structural) defect in the eye or in the visual pathways. It’s one of the few situations where neither the patient sees anything nor the doctor can find any organic injury in the eye. Clinical diagnosis of amblyopia is made when a minimum difference of two lines is found between the patient’s vision with the best optical correction, and it’s confirmed by a difference of at least two lines on the Snellen chart. This means that the eye with poorer vision is amblyopic, provided that no organic defect responsible for the reduction of vision can be found in the deeper layers of the eye.

The factors causing Amblyopia

Congenital abnormalities in the eye structure, such as cataracts and drooping eyelids, can prevent the eye from forming a clear image of objects and gradually lead to amblyopia. In the case of cataracts, the best treatment is surgical intervention, which, if performed as soon as possible after birth up to three months of age, will yield better results. However, after three months of age, the results may not be as satisfactory. In conditions like nearsightedness, farsightedness, and astigmatism, if the vision in both eyes is severely impaired, both eyes can’t form a clear image of objects, and they become progressively amblyopic. Strabismus, or eye misalignment, can also result in double vision, and as a result, the brain gradually suppresses the image from the misaligned eye, leading to amblyopia.

Prevention and treatment

The only way to prevent amblyopia is early detection of its causative factors. Since many of these factors are unknown to families, all children should be examined at least three times before entering elementary school at various times. Also, if a child has strabismus (eye misalignment), parents should take them to a specialist for treatment as soon as it’s diagnosed.

The treatment for amblyopia typically involves patching the healthy eye to encourage the amblyopic eye to work and recover its vision. The duration of patching is determined by a specialist and should be monitored at regular intervals by a specialist. In some cases, glasses or surgery may be recommended for treatment. If amblyopia is due to congenital conditions like cataracts or ptosis, it should be treated before three months of age. If it’s due to other causes, effective treatment is possible until before the age of five. After that, treatment is generally less effective. Sometimes the treatment duration can be several years. In this case, parents must have patience, persistence, and the necessary endurance and not be exhausted by frequent visits to the specialist and other associated challenges. If the specialist recommends patching your child’s eye, follow their instructions and don’t patch the eye for less or more time than prescribed. If amblyopia is diagnosed, be sure to monitor your child’s vision and changes in refractive errors until the age of ten.

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