Amblyopia is a disease of the visual organs, which is characterized by impaired visual functions and is accompanied by a progressive deterioration in visual acuity, color perception and the inability to focus the gaze. Amblyopia is also known as lazy eye syndrome.
If a person has amblyopia, they have problems with orientation in space: it becomes difficult to objectively assess the distances between objects, and the perception of volume and depth decreases. Increased stress on the healthy eye also leads to unpleasant consequences: patients complain of frequent headaches and a feeling of pain in the eyes.
Often, such phenomena are observed in only one eye; in practice, quite rarely there are cases when the lesion affects both eyes.
The peculiarity of the disease is that the retina and optic nerve, which are responsible for vision, are not damaged, but vision continues to decline. This is due to the fact that one eye perceives the picture much worse; the brain disconnects the affected eye from the vision process.
However, the preservation of the visual analyzer in a fully functioning state gives grounds for a favorable prognosis - the syndrome can be corrected, but only if treatment is carried out in the early stages of the disease.
Amblyopia or “lazy eye” is a decrease in visual acuity in an eye that does not have any external signs of disease. Neither examination of the anterior segment of the eye, the fundus, nor generally accepted examination methods usually indicate a problem. Amblyopia is diagnosed in childhood when testing visual acuity and is associated with insufficient development of the visual analyzer, when a defocused or unclear image appears on the retina.
Approximately 2% of the world's population suffers from amblyopia. This pathology most often develops in childhood and is often accompanied by other vision diseases.
What is amblyopia
Amblyopia is a persistent progressive decrease in vision in one or both eyes in the absence of pathological structural changes. Another name for the pathology is “lazy eye” syndrome.
Most often, with amblyopia, the visual function of one eye is suppressed. That is, a person perceives an image with only one healthy eye, monocularly, while the second eye does not participate in the visual process. In this case, we are not talking about blindness; the suppressed visual organ retains its functions. That is why the disease is considered reversible if treatment is started in time.
Amblyopia is a reversible disease, but it is important to start treatment on time
The suppressed eye gradually loses visual acuity, accommodative abilities and contrast sensitivity. Therefore, treatment for amblyopia must begin as early as possible, before all visual functions in the affected eye are impaired.
In rare cases, amblyopia can affect both eyes.
Causes of amblyopia
In fact, there are many reasons leading to the development of lazy eye syndrome. An ophthalmologist will be able to identify the exact cause only after a complete vision diagnosis. But experts identify the main risk factors that can cause amblyopia. Among them:
- Strabismus;
- Myopia, farsightedness, astigmatism;
- Eye injuries and retinal surgeries;
- Cerebral paralysis;
- Heredity or congenital abnormalities;
- Weakness of the accommodative apparatus;
- Incorrectly selected vision correction;
- Stress, hysterical states, psychosis.
Amblyopia can affect children with abnormal intrauterine development. For example, the disease is diagnosed in people with mental retardation, low birth weight, and prematurity. If during pregnancy the child’s mother smoked, took alcohol, drugs or medications contraindicated for pregnant women, the risk of developing amblyopia in the child increases several times.
However, experts note that amblyopia can also develop in people who do not have a genetic predisposition to the disorder.
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Visometry
The procedure is carried out to determine the visual acuity of a child using special tables that depict pictures or letters, depending on the age of the baby. At a distance of 5 meters from the table, the patient closes one eye, after which he names the picture or letter that the doctor points to. The test is carried out for each eye under certain room lighting.
The results may be influenced by some factors that are taken into account by the specialist - the baby finds himself in an unfamiliar environment, so he can easily get scared and give incorrect answers. To prevent this situation, it is important to create a trusting relationship between the child and the doctor. It is also necessary to make sure that the patient knows the letters and pictures present on the table.
If a young child cannot name pictures, amblyopia may be suspected if there is a negative reaction to occlusion (gluing) in the better-seeing eye.
Identification of visual impairment at the initial consultation requires a repeat procedure. Subsequent examination begins with the visually impaired eye.
Types of amblyopia
The classification of the disorder depends on the causes of the “lazy eye” syndrome.
Refractive amblyopia
appears against the background of such visual disorders as farsightedness, myopia, astigmatism, anisometropia. Amblyopia develops due to the lack of a clear image on the retina.
Dysbinocular amblyopia
appears with strabismus. This is the most common cause of amblyopia. With strabismus, the eyes perceive two different images. The brain is not able to connect the image from both eyes and process the information received, so the image transmitted by the weaker eye is simply suppressed. In fact, the very principle of binocular vision, in which two images are compared by the brain into a single picture, is violated.
Obscurational amblyopia
People suffer from diseases that prevent the flow of rays to the retina of the eye - cataracts, cataracts, destruction of the vitreous body.
Dysbinocular amblyopia and refractive amblyopia are classified as primary types of disorder, obscuration is considered a secondary type.
Symptoms of amblyopia in children and adults
Amblyopia develops gradually and often goes unnoticed in the early stages. Moreover, the sooner treatment of the pathology begins, the better the results will be. This is why it is important to visit an ophthalmologist at least once a year, even if the patient is not worried about anything.
Children with amblyopia may appear clumsy and have trouble spatial awareness
General symptoms do not differ from other ophthalmological diseases - blurred vision, sensation of a foreign object in the eye, frequent headaches, increased fatigue with high visual load.
Symptoms more characteristic of amblyopia may appear already at a moderate and high degree of development of the disorder:
- There are difficulties with focusing at near and far distances;
- The ability to distinguish shades deteriorates;
- The outlines of objects may become blurred;
- The eyelid of the affected eye droops;
- To view an object, a person with amblyopia must cover the affected eye with the palm of their hand;
- The eyeball may make involuntary movements;
- Volumetric objects are more difficult to perceive.
Children may not be aware of their problems, so it is important for adults to monitor the child’s behavior and pay attention to characteristic changes in time.
For example, a child may tilt their head to the right or left to look at an object. Children with amblyopia have poor orientation and their movements may appear clumsy from the outside. With amblyopia, the affected eye may deviate to the side; this occurs when the child is concentrating on something. The easiest way to notice this deviation is when a child is watching a cartoon or reading.
An ophthalmologist can diagnose the disease only after a comprehensive examination. To detect possible violations in time, visit a specialist at least once a year! Children are recommended to undergo preventive examinations at least twice a year.
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Treatment of amblyopia
The disease is reversible, but the effectiveness of treatment directly depends on the degree of the disorder. With mild to moderate amblyopia, the chances of curing the disease are quite good, but if amblyopia has reached a very high degree, treatment may be ineffective.
All treatment methods for amblyopia are aimed primarily at restoring binocular vision and increasing visual acuity in the visually impaired eye. The specialist chooses a method based on the degree of the disease and the cause of its occurrence.
Vision correction
If the cause of amblyopia is myopia, farsightedness or astigmatism, the first step is to correct your vision with glasses or contact lenses. It is important that the selection of correction is carried out by an experienced specialist, since incorrect diopters can also affect the development of lazy eye syndrome.
Amblyopia can be corrected with glasses or contact lenses
With the help of correction, the rays will focus on the retina correctly, this stimulates the “lazy” eye to independently engage in the visual process.
Occlusions
This method is used for almost any type of amblyopia. The bottom line is this: the healthy eye is closed using an occluder, that is, a safe pad made of plastic, rubber or fabric. This naturally awakens the amblyopic eye, it begins to work more intensely and is fully involved in the visual process.
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Hardware treatment (pleoptics)
Restoration of binocular vision in this case occurs through complex treatment using special computer programs and medical equipment.
Pleoptics course
allows you to restore binocular vision in case of advanced amblyopia.
Surgery
If amblyopia occurs as a result of strabismus, treatment may include surgery aimed at eliminating the factor in the development of lazy eye syndrome.
Current issues
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Is surgery for strabismus performed on both eyes at once?
Sometimes both eyes are operated on at once; in some types of strabismus, only one eye is operated on.
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Why is hardware treatment also recommended after surgery?
Surgery for strabismus is primarily a cosmetic remedy, since in itself it rarely restores binocular vision (when the brain combines two images received by the eyes into one). Each eye of a person with normal vision receives slightly different images (you can verify this by closing first one eye and then the other), which the brain combines into one. This does not happen with strabismus. In order for a person to see one picture and not two, surgery alone is not enough. The brain is not used to this kind of work. Therefore, to restore binocular (3D) vision, special exercises are necessary for a long time. At Excimer clinics, complex vision stimulation and hardware treatment help solve this problem.
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If the child has strabismus, a bandage is applied to the healthy eye. Treatment takes a long time. Will he “forget” how to see with it?
Treatment using this method requires constant monitoring of the visual acuity of the healthy eye, and to improve the visual acuity of the worse eye, there is a special complex of hardware treatment (laser therapy, amblyocor, electrical stimulation, etc.) Occlusion (gluing or bandaging the healthy eye) is one of the parts of the complex treatment - must be strictly monitored by the attending physician.
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conclusions
Lazy eye syndrome can appear for various reasons, but most often it is provoked by strabismus, myopia, farsightedness, astigmatism, cataracts and other ophthalmological diseases.
With amblyopia, the visual function of one eye (less often both) is suppressed, as a result of which binocular vision is impaired. Amblyopia can be treated in the early and middle stages of development, but the disease of a very high degree is almost impossible to cure.
To treat amblyopia, various methods are used, including vision correction, occlusion and pleoptics. The ophthalmologist chooses a method based on the causes of the disease and the degree of its development.
The sooner treatment begins, the higher the chances of complete vision restoration! Have a preventive examination with an ophthalmologist at least once a year and bring your children at least twice a year; only in this case can the disorder be detected and corrected in time.
Diagnostics
Early diagnosis of the disease (at the age of 3-4 years) makes it possible to cure amblyopia. Regular comprehensive examination by an ophthalmologist is the first step to identifying eye diseases and preventing their development.
An initial examination by a doctor makes it possible to determine the presence of signs of the disease. Additional examination using modern techniques makes it possible to accurately identify amblyopia, the causes of its occurrence, the degree of development of the disease and prescribe effective treatment.
Doctors use advanced diagnostic methods:
- Functional ophthalmic tests are performed to check visual acuity, color perception and perimetry.
- Carrying out biometric studies makes it possible to determine the angle of strabismus.
- Also used are studies of eye refraction, assessment of fixation, and accommodation. Various electrophysiological examination methods help to complete the picture of the disease.
- If necessary, for a more accurate and complete study of the course of the patient’s disease, an ultrasound of the eye, an MRI of the brain, and a consultation with a neurologist can be performed.
Visiting an ophthalmologist twice a year throughout the child’s growth and development, even in the absence of complaints, will eliminate the presence of pathologies or identify them in their infancy.
