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Amblyopia or Lazy Eye

Amblyopia also called lazy eye is decreased eyesight or it’s a type of poor vision that happens in 1 eye.
The most sensitive period of developing amblyopia is in the first 6 months and after about the age of 6 years. Amblyopia does not usually develops, but when there’s a breakdown in how your brain and the eye work together, and the brain can’t recognize the sight from one eye.

Amblyopia starts in childhood, and it’s the most common cause of vision loss in children. Up to 3 out of 100 kids have it. If you treat in early that’s work well.

Types of amblyopia

Strabismic:-Misalignment of eyes results in visual cortex suppression of the visual input of the deviating eye.

Combined strabismic and anisotropic:- Eye misalignment and refractive errors leads to visual cortex suppression of the chronically blurred image.

Anisotropic amblyopia:-
Diffrence of visual acuity(refractive error) between eyes leads to visual blurring of one eye and visual cortex suppression of the visual input of the blurred eye.

Stimulas deprivation amblyopia:-
Results from thr nonuse of one eye in infancy or early childhood and is caused by opacity in the media, ptosis or by occlusion.

Causes of amblyopia:-
In many cases, doctors don’t know the cause of amblyopia. But sometimes a different vision problem can lead to amblyopia. Normally, the brain nerve signals from both eyes to see. But if an eye conditions makes vision in one eye worse thr brain may try to work around it. It starts ti “turn off” Signals from the weaker eye and depend only thr stronget eye.

Some eye conditions thag can lead to amblyopia are –

Refractive errors:- These include common vision problem like near-Sightness, far-sightness, and astigmatism.

Normally, these problems are easy to fix with glasses or contact lense. But if it not treated early the brain start ti depends o the eye with stronger vision.

The kost common cause of lazy eye is an imbalance in thr muscle that position the eyes. This imbalance can cause the eye to errors in or turn out and prevents them from working together.

This cause hazy in the lens of the eye making things look blurry. While most cataract happen in older people,children can also develop cataracts.

Characteristics or symptoms of an amblyopic eye:-
•Decrease in visual acuity.
•Crowding phenomenon:-vision is better when the test letter are viewed singly(optotype), rather than a series (snellen’s chart)
•Neutral density filter test:-Amblyopic eye shows no change in visual acuity with a neutral density filter. But a normal eye shows a drop in acuity of about one or two lines, whereas an eye with macular lesion may have a large drop in visual acuity.
•Color vision unaffected.

Treatment:-An ophthalmologist or optometrist diagnose amblyopia by checking to see if vision differs between the two check a baby’s or young child’s vision they may cover one of the eyes and watch how well they can follow a moving object. The doctor also watch how the child reacts when one eye is covered.

∆There are three types of treatment.
•Removal of opacity in the media.
•Correction of refractive errors.
•Occulusion therapy.

If there are vision problem causing amblyopia, the doctor or optometrist treat that first recommend a glasses or contact lens.

Conventional occlusion:-
•If the vision tn the lazy eye is worse than 6/18 occlusion must be total(It’s required direct patching of the eye) .
•If the vision is >6/18 the occlusion must be partial(with the help of cellotape over the spectacle lens).
•Occlusion must given in ratio. One day in lazy eye or amblyopic eye and next 3 days in better or good eye.
•Occlusion therapy should to be continued until the visual acuity recoverd fully or if there is no improvement of vision for more than three months.

Putting special eye drop in the stronger eye:-
A once a day drop of the drug atropine can temporarily blur near vision. Which forces the brain to use the other eye. For some kids this treatment works as well as an eye patch, and some parents like it because it’s is easier to use.

These treatment should be started early as soon as possible for the amblyopic eye. After starts the treatment, their vision start to better within few weeks but it’ll probably take some months to get the better improvement. After that, your child still need to these treatment from time to time to stop amblyopia.

Riju Ghosh

Future optometrist at diamond harbour government medical college and hospital. Member of optography.

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