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Amblyopia

Amblyopia, also called lazy eye, is a disorder of sight. It results in decreased vision in an eye that otherwise appears normal, or out of proportion to associated structural problems of the eye.

Whenever the brain does not receive visual signals from an eye for a long period of time, there is a risk of amblyopia. It also can occur when the brain “turns off” the visual processing of one eye to prevent double-vision, for example in strabismus (crossed eyes). The cause of amblyopia is within the brain. Detecting the condition in early childhood increases the chance of successful treatment, especially if detected before the age of five. The earlier it is detected, and the underlying cause corrected with glasses or surgery, the better the long term outcomes.

Pathology

Amblyopia is a developmental problem in the brain, not any intrinsic, organic neurological problem in the eyeball (although organic problems can lead to amblyopia which can continue to exist after the organic problem has resolved by medical intervention). The part of the brain receiving images from the affected eye is not stimulated properly and does not develop to its full visual potential.

Signs and symptoms

Many people with amblyopia, especially those who only have a mild form, are not even aware they have the condition until tested at older ages, since the vision in their stronger eye is normal.

Types

Amblyopia has three main causes:

Strabismus:

by strabismus (misaligned eyes)

Refractive:

by anisometropia (high degrees of nearsightedness, farsightedness, or astigmatism in one or both eyes).

Deprivational:

by deprivation of vision early in life by vision-obstructing disorders such as congenital cataract.

Amblyopia Treatment

Deprivation amblyopia is treated by removing the opacity as soon as possible followed by patching or penalizing the good eye to encourage the use of the amblyopic eye. The earlier the treatment is initiated, the easier and faster the treatment is and the less psychologically damaging. There is also a greater chance of achieving 20/20 vision if treatment is initiated as early as possible.

Consult your pediatric ophthalmologist for further management.

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