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Amblyopia

Generality/Definition
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    Amblyopia, also known as lazy eye, is a condition in which one eye has reduced vision. Lack of brain stimulation from the weaker eye causes the strong eye to become dominant. The amblyopic eye is suppressed and may even become blind. Amblyopia may be caused by: 1- Misaligned or crossed eyes , 2- A difference in visual acuity between the two eyes (a difference of at least one line on a Snellen Visual Acuity Chart), 3- Less commonly, amblyopia develops when one eye is more nearsighted, farsighted, or astigmatic, or suffers from cataract.
    Source: Provisu look Amblyopia (uniteforsight.org)
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Epidemiology

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    In the US: Prevalence of amblyopia is difficult to assess and varies in the literature, ranging from 1.0-3.5% in healthy children to 4.0-5.3% in children with ophthalmic problems. Most data show that about 2% of the general population has amblyopia while bilateral amblyopia is estimated to be around 0.5% of the population. Amblyopia was shown in the Visual Acuity Impairment Survey sponsored by the National Eye Institute (NEI) to be the leading cause of monocular vision loss in adults aged 20-70 years or older. Prevalence of amblyopia has not changed much over the years. Amblyopia occurs during the critical periods of visual development. An increased risk exists in those children who are developmentally delayed, were premature, and/or have a positive family history.
    Source: Provisu look Amblyopia (emedicine.com)
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Prevention

Symptoms

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    Amblyopia generally develops in young children, before age six. Its symptoms often are noted by parents, caregivers or health-care professionals. If a child squints or completely closes one eye to see, he or she may have amblyopia. Other signs include overall poor visual acuity, eyestrain and headaches.
    Source: Provisu look Amblyopia or Lazy Eye (allaboutvision.com)
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Diagnosis

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    While a deviating eye (strabismus) may be easily spotted by the layman, amblyopia without strabismus or associated with a small deviation usually can be not noticed by either you or your pediatrician. Only an eye doctor comfortable in examining young children and infants can detect this type of amblyopia. This is why early infant and pre-school eye examinations are so necessary. The most important diagnostic tools are the special visual acuity tests other than the standard 20/20 letter charts currently used by schools, pediatricians and eye doctors. Examination with cycloplegic drops can be necessary to detect this condition in the young.
    Source: Provisu look Amblyopia (strabismus.org)

Treatment

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    Amblyopia can be successfully treated up to the age of 17. Early treatment is usually simple, employing glasses, drops, vision therapy and/or patching. Detection and correction before the age of two offers the best chance for a cure. Treatment of amblyopia after the age of 17 is not dependent upon age but requires more effort including vision therapy. Every amblyopic patient deserves an attempt at treatment.
    Bilateral amblyopia can be treated with spectacles which improves binocular visual acuity between children aged 3 and 10years of age. A one of a kind research has been conducted in the UK using a I-BiT system which consists of a desk top viewer which is linked to a PC. Games are displayed on the PC where the screen displayed to either eye is half of the whole picture, thus forcing the brain to join these 2 images and create the whole picutre. This treatment would be especially useful for bilateral amblyopia, where patching and use of eye drops are of no help. More information on this research is found at: http://www.virart.nottingham.ac.uk/ibit/technology2.htm
    Source: Provisu look Amblyopia (strabismus.org)
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Illustrations

Source: Provisu look Amblyopia or Lazy Eye (i1.allaboutvision.com)


You can help your child accept patching by making it fun. Shown here are eye patch stickers by Eye-Doodle.

Source: Provisu look Keith Seidenberg, MD, Ophthalmologist (kseidenberg.com)


To correct amblyopia, a child must be made to use the weak eye.

Information for specialists

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    Older Children May Benefit from Lazy Eye Treatments :
    Surprising results from a nationwide study show that older children may benefit from traditional therapies for lazy eye (amblyopia), the National Eye Institute (NEI) announced. Many eyecare providers previously thought that only very young children up to about age 7 could benefit from therapies such as eye patching, eye drops, and activities for improving near vision, the NEI said. Lazy eye typically develops beginning in infancy when the eye-brain connection fails to develop properly, resulting in one eye becoming extremely dominant. The non-dominant eye in lazy eye eventually may become blind. Doctors can now feel confident that traditional treatments for amblyopia will work for many older children, NEI Director Paul A. Sieving, M.D., PhD, said in a news release. This is important because it is estimated that as many as 3% of children in the United States have some degree of vision impairment due to amblyopia. Many of these children do not receive treatment while they are young. In the study reported in the April 2005 issue of Archives of Ophthalmology, many of 507 older children ages 7-17 had vision improvement when traditional lazy eye therapies were used.
    Source: Provisu look Amblyopia or Lazy Eye (allaboutvision.com)

Scientific articles: All recent articles for "Amblyopia"

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Last modified: Jan 2014
Creation: Jan 2006