Treatment of Amblyopia

Amblyopia, known as "lazy eye," is a condition that primarily affects vision in one eye, leading to reduced visual sensitivity. Although it is often diagnosed in childhood, it can persist into adulthood if not properly treated. The good news is that with early intervention and appropriate treatment, significant improvements can be achieved. At the Dobrobut Clinic, our experienced ophthalmologists aim to provide personalized care for patients with amblyopia, ensuring the best possible outcomes.

Types of Amblyopia

There are several main types of amblyopia:

• Refractive Amblyopia: This occurs when one eye has a significant difference in visual acuity compared to the other, due to astigmatism, myopia, or hyperopia, and insufficient correction of these conditions. The brain may favor the eye with better vision, leading to decreased use of the other eye.
• Strabismic Amblyopia: In this type, the eyes are misaligned due to strabismus, which can cause double vision or confusion in depth perception. The brain suppresses the image from one eye to avoid this confusion, resulting in amblyopia.
• Deprivation Amblyopia: This arises when there is a physical obstruction of light entering the eye, such as a cataract in infants, which can hinder visual development.

Causes

Amblyopia can develop due to several causes:

• Refractive errors: Significant differences in vision between the two eyes.
• Strabismus: Constant or periodic misalignment where one or both eyes cannot focus on the same object.
• Visual deprivation: Conditions like cataract or ptosis that obstruct clear vision.
• Genetic and hereditary factors.
• Childhood illnesses: Infections or neurological disorders that can affect vision development.

Understanding the cause is crucial for effective treatment, as each type may require a different approach.

Symptoms of Amblyopia

Amblyopia may manifest differently, especially in children and adults. People with amblyopia often may not realize they have a vision problem, as this condition usually affects only one eye, allowing the brain to adapt.

Signs to watch for include:

• Reduced vision in one eye compared to the other, which may only be noticeable during vision tests.
• Strabismus (crossed eyes).
• Poor depth perception: Difficulties in judging distances and seeing in 3D, impacting activities like sports or driving.
• Squinting or closing one eye to see better, especially in bright light or when focusing on objects.
• Difficulties with reading, writing, or recognizing faces.
• Unusual head posture, such as tilting the head to see objects, to compensate for eye misalignment.

When to See a Doctor

It is crucial to see a doctor if any signs of amblyopia appear in a child or an adult. Early detection and treatment are key to improving visual outcomes, ideally before the age of seven. Parents should monitor their child’s behavior closely to ensure timely consultation with an ophthalmologist, as amblyopia often develops without obvious signs.

Diagnosis of Amblyopia

Diagnosis involves a thorough ophthalmic examination and a series of specialized tests to evaluate the visual functions of each eye. Modern diagnostic methods have significantly improved, allowing for greater accuracy in detecting and assessing amblyopia.

Diagnostic methods include:

1. Comprehensive ophthalmological examination to review visual complaints, overall child development, medical history, and family history. Tests for visual acuity of each eye are conducted using standardized visual charts and reading letters or symbols at various distances.
2. Refraction tests include assessing subjective refraction, where the patient is presented with different lens options to determine which provides clearer images, and objective refraction, measured with devices (e.g., autorefractors) that automatically diagnose refractive errors.
3. Assessment of binocular vision, which provides insight into how both eyes work together and is crucial for diagnosing amblyopia: eyes are alternately covered, and the doctor evaluates their movement.
4. Pupil reaction tests to light help detect underlying neurological issues that could affect vision.
5. Depth perception tests using special cards and glasses.
6. Visual field testing.
7. Modern Instrumental Methods:
   1. Optical Coherence Tomography (OCT): This non-invasive technique provides high-resolution images of the retina and optic nerve.
   2. Detailed retinal images.
8. Specialized visual assessment tools to measure specific functions such as contrast sensitivity, and color vision tests.

These assessments help identify the type of amblyopia and tailor an appropriate treatment plan.

Treatment of Amblyopia

Early detection and treatment are critical for the best chances of vision recovery. While treatment is most effective in childhood, improvements can also be observed in older patients.

Treatment aims to enhance the weaker eye's function and restore binocular vision. The approach depends on the type of amblyopia and the patient's individual needs.

Main treatment methods include:

Corrective lenses: Prescription glasses or contact lenses help correct nearsightedness, farsightedness, or astigmatism to improve vision in the weaker eye if refractive amblyopia is diagnosed.

Occlusion therapy: Involves covering the stronger eye, one of the most common treatment methods, especially for children. The stronger eye is occluded for a specified period during the day, forcing the brain to use the weaker eye, which promotes its development. Duration and frequency of treatment depend on the severity of the condition and the patient's age.

Vision therapy: Incorporates structured visual activities and exercises aimed at enhancing visual skills and processing, potentially improving accommodation and coordination.

Surgical methods: Indicated in cases where amblyopia is associated with complex strabismus cases.

Device-based treatment: Involves using specialized devices and technologies to improve vision in the weaker eye. This treatment is often combined with other methods, such as glasses, and can be especially effective in children.

• Computerized vision therapy: Uses computer programs to complete specific tasks aimed at improving visual skills, including games and programs to train focusing, tracking moving objects, and depth perception.
• Synoptic trainers: Devices that create a stereoscopic effect, promoting binocular vision development. They display images that require both eyes for a clear and coherent view, beneficial for patients with amblyopia due to strabismus.
• Depth perception trainers: May include elements requiring three-dimensional perception, helping the brain integrate information from both eyes.
• Virtual reality (VR) exercises: Programs providing interactive experiences for patients to work on various aspects of vision in a game-like format.
• Retinal stimulation devices: Use light signals to stimulate the weaker eye’s retina, often used in combination with other treatment methods.

Advantages of Device-Based Treatment

• Appealing to children.
• Treatment individualization.
• Systematic approach.

Complications

Untreated amblyopia can lead to long-term complications such as poor vision in the affected eye during adolescence and adulthood; increased risk of vision loss from eye diseases in adulthood; and reduced quality of life and academic performance, particularly in tasks requiring good vision.

Prevention

Measures to reduce the risk of developing amblyopia include:

• Regular eye exams for children, especially if there is a family history of vision problems.
• Timely treatment of any refractive errors (ametropia) and eye diseases.
• Educating parents about signs of visual disturbances.

With prompt and appropriate treatment, many patients with amblyopia can significantly restore their vision. The earlier the intervention, the higher the chances of effective treatment, improving daily activities and enhancing overall quality of life.

You can schedule a consultation with an ophthalmologist through the form on the website or by calling the contact center.